Antimicrobials
Gentamicin

Gentamicin

Low
N/A

Spectrum of Activity

General Information

HEALTH CANADA APPROVED

  • Treatment of serious infections due to susceptible aerobic gram-negative bacteria
  • In synergistic combination regimens for treatment of certain pathogens including enterococci or viridans streptococci, S. aureus, S. epidermidis and L. monocytogenes
  • Duration of therapy: Increased risk of nephrotoxicity
  • Neuromuscular disease, hypocalcemia or hypomagnesemia: Can exacerbate neuromuscular blockade
  • Loop diuretics (eg ethacrynic acid, furosemide) - additive ototoxicity
  • Nephrotoxic drugs (eg amphotericin B, cycloSPORINE, NSAIDS and contrast dye) - increased risk of nephrotoxicity
  • Neuromuscular blocking agents and general anesthetics - possible prolonged action and/or respiratory paralysis
  • Extended spectrum penicillins (eg piperacillin/tazobactam) may chemically inactivate gentamicin and reduce serum levels. Usually only clinically significant in patients with severe renal impairment

RENAL

  • Nephrotoxicity – dose related; more frequent during prolonged therapy. Usually reversible

NEUROLOGIC

  • Ototoxicity: Eighth cranial nerve damage (auditory and vestibular) associated with excessive doses in renal failure. May be irreversible
  • Neuromuscular blockade (rare): Calcium may help to reverse

Formal audiology assessment if planning to use aminoglycoside for >7d or if symptoms develop.

Inform patient of risk of ototoxicity and to report any symptoms.

Antimicrobial class: Aminoglycoside

Pregnancy category: D

Average serum half life: 2 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Moderate

pH: 3 to 5.5