Gentamicin

Usual Dosing (Adults)

Dosing (Adults): I.M., I.V.: Systemic infections:
Severe, life-threatening infections:
Conventional dosing: 2-2.5 mg/kg/dose every 8-12 hours; to ensure adequate peak concentrations early in therapy, higher initial dosages may be considered in selected patients when extracellular water is increased (edema, septic shock, postsurgical, or trauma)

Once-daily dosing: Some clinicians suggest a daily dose of 4-7 mg/kg once daily for all patients with normal renal function; this dose is at least as efficacious with similar, if not less, toxicity than conventional dosing.

Urinary tract infections: 1.5 mg/kg/dose every 8 hours

Synergy (for gram-positive infections): 1 mg/kg/dose

Prevention of bacterial endocarditis:
Dental, oral, or upper respiratory procedures: 1.5 mg/kg (not to exceed 80 mg) with ampicillin (1-2 g) 30 minutes prior to procedure

GI/GU surgery: 1.5 mg/kg (not to exceed 80 mg) with ampicillin (2 g) 30 minutes prior to procedure

Renal Dosing

Dosing interval in renal impairment:
Conventional dosing:
Clcr >/=60 mL/minute: Administer every 8 hours
Clcr 40-60 mL/minute: Administer every 12 hours
Clcr 20-40 mL/minute: Administer every 24 hours
Clcr<20 mL/minute: Loading dose, then monitor levels

High-dose therapy: Interval may be extended (eg, every 48 hours) in patients with moderate renal impairment (Clcr 30-59 mL/minute) and/or adjusted based on serum level determinations.

Hemodialysis

Hemodialysis: Dialyzable; removal by hemodialysis: 30% removal of aminoglycosides occurs during 4 hours of HD; administer dose after dialysis and follow levels.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates. A local search option of this data can be found here.