Consult pharmacy for all patients receiving gentamicin for therapeutic drug monitoring and dose individualization.
Monitor creatinine at least 2 - 3 times/week.
Formal audiology testing is recommended if therapy is planned to last greater than 2 weeks or symptoms occur. Discontinue if any signs of ototoxicity.
Multiple daily dosing:
Serum levels recommended around the third dose following initial therapy or with any change in dose:
- Pre-dose level: 0 to 30 minutes before next dose (should be less than 2 mg/L)
- Post-dose level: 30 minutes after completion of an IV infusion (should be 6 - 10 mg/L, target can be lower for urinary tract infections and for synergy)
Once daily dosing: target trough: < 1 mg/L (peak levels not required)
Check gentamicin levels earlier in patients with impaired renal function