General Information

Pseudomonal and other gram negative infections, inhaled form used in cystic fibrosis

  • Nephrotoxicity (non-oliguric) - less common with once daily dosing; greater toxicity with longer duration and supratherapeutic trough levels; avoid concomitant nephrotoxins
  • Vestibulocochlear toxicity (irreversible)- suggest audiology testing if prolonged use
  • Can exacerbate neuromuscular blockade- e.g. contraindicated in patients with myasthenia gravis.
  • Enhanced nephrotoxic effect with concomitant use of other nephrotoxins
  • Enhanced ototoxicity with loop diuretics (e.g. furosemide).
  • Non-depolarizing muscle relaxants may be potentiated.

Antimicrobial class: Aminoglycoside

Average serum half life:

  • Neonates: ≤1200 g: 11 hours, >1,200 g: 2 to 9 hours.
  • Infants: 4 ± 1 hour.
  • Children: 2 ± 1 hour.
  • Adolescents: 1.5 ± 1 hour
  • Adults: IV: 1-2 hours; directly dependent upon glomerular filtration rate
  • Adults with impaired renal function: 5- 70 hours

Route of Elimination: With normal renal function, 93% of dose excreted in urine within 24 hours