Dosing Guidlines for Adults
Drug Detail for Adult Drugs
Gentamicin
Antimicrobial Agents
Antibacterial Antibiotics
Aminoglycoside Antibiotics
- General Toxicity Notes
- Nephrotoxic, ototoxic. Toxicity worse when hyperbilirubinemic. Measure serum levels for efficacy and toxicity. Peritoneal absorption increases with presence of inflammation. Vd increases with edema, obesity, and ascites. Do not use once-daily dosing in patients with CrCl <30-40 mL/min or in patients with acute renal failure or uncertain level of kidney function.
- Excreted Unchanged %
- 95
- Half-Life (NormalESRD) hours
- 1.8/20-60
- Plasma Protein Binding %
- <5
- Volume of Distribution L/kg
- 0.23-0.26
- Dose for Normal Renal Function
- 1.7 mg/kg q8h or 5-7 mg/kg qd
- Second Dose
-
- Adjustment for Renal Failure Method
- I
- Adjustment for Renal Failure GFR, mL/min >50 [Recommended Level]
- 100% q8-24h [A]
- Adjustment for Renal Failure GFR, mL/min 10-50 [Recommended Level]
- 100% q12-48h by levels [A]
- Adjustment for Renal Failure GFR, mL/min <10 [Recommended Level]
- 100% q48-72h by levels [A]
- Supplement for Dialysis [Recommendation Level]: IHD
- IHD: full dose after dialysis
- Supplement for Dialysis [Recommendation Level]: PD
- PD: 3-4 mg/L/d
- Supplement for Dialysis [Recommendation Level]: CRRT
- CRRT: Dose for GFR 10-50, monitor levels, [A]
- References
- de Paepe M, Lameire N, Belpaire F, Bogaert M. Peritoneal pharmacokinetics of gentamicin in man. Clin Nephrol. 1983; 19: 107-9. [PMID: 6839558] / Ernest D, Cutler DJ. Gentamicin clearance during continuous arteriovenous hemodiafiltration. Crit Care Med. 1992; 20: 586-9. [PMID: 1572182] / Pancorbo S, Comty C. Pharmacokinetics of gentamicin in patients undergoing continuous ambulatory peritoneal dialysis. Antimicrob Agents Chemother. 1981; 19: 605-7. [PMID: 7247382] / Thomson AH, Grant AC, Rodger RS, Hughes RL. Gentamicin and vancomycin removal by continuous venovenous hemofiltration. DICP. 1991; 25: 127-9. [PMID: 2058183]
- Toxicity Notes
-