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gentamicin

Pronunciation

Generic Name: gentamicin (gen tah MY sin)
Brand Name: Garamycin, Cidomycin, Septopal

What is gentamicin?

Gentamicin is an antibiotic. It fights bacteria in the body.

Gentamicin is used to treat severe or serious bacterial infections.

Gentamicin may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about gentamicin?

If you are injecting gentamicin at home, your healthcare provider will give you detailed instructions on how and where to inject the medication. If you do not understand these directions, do not attempt to inject the medication. Contact your healthcare provider for further instructions.

Slideshow: View Frightful (But Dead Serious) Drug Side Effects

Gentamicin may cause damage to the kidneys and/or nerves. Kidney function and drug levels in the blood may be monitored with blood tests during treatment. Tell your doctor if you experience hearing loss, dizziness, numbness, skin tingling, muscle twitching, or seizures which may be signs of nerve damage.

What should I discuss with my healthcare provider before using gentamicin?

Do not use gentamicin without first talking to your doctor if you have

  • sulfite sensitivity;

  • kidney disease;

  • hearing loss or loss of balance due to ear problems;

  • Parkinson's disease; or

  • a neuromuscular disorder such as myasthenia gravis.

You may not be able to use gentamicin, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Do not use gentamicin without first talking to your doctor if you are pregnant or could become pregnant during treatment.

Do not use gentamicin without first talking to your doctor if you are breast-feeding a baby.

How should I take gentamicin?

If you are injecting gentamicin at home, your healthcare provider will give you detailed instructions on how and where to inject the medication. If you do not understand these directions, do not attempt to inject the medication. Contact your healthcare provider for further instructions.

Do not use any gentamicin that is discolored, has particles in it, or looks different from your previous doses. Throw away any unused gentamicin after the amount of time determined by your pharmacist or doctor.

Adequate hydration is important during treatment with gentamicin. Fluids may be administered intravenously during treatment.

It is important that the medication be given on a regular schedule and for the entire amount of time prescribed by your doctor.

Gentamicin may cause damage to the kidneys and/or nerves. Kidney function and drug levels in the blood may be monitored with blood tests during treatment. Tell your doctor if you experience hearing loss, dizziness, numbness, skin tingling, muscle twitching, or seizures which may be signs of nerve damage.

Dispose of used needles and syringes in a puncture resistant container out of the reach of children.

Your healthcare provider will store gentamicin as directed by the manufacturer or give you detailed storage instructions if you are storing the medication at home.

What happens if I miss a dose?

Contact your doctor if a dose is missed.

What happens if I overdose?

Contact your doctor or seek emergency medical attention if an overdose is suspected. An overdose of the medication may result in damage to the kidneys or hearing loss, dizziness, numbness, skin tingling, muscle twitching, or seizures (which may be signs of nerve damage).

What should I avoid while taking gentamicin?

There are no restrictions on food, beverages, or activity while taking gentamicin unless otherwise directed by your doctor.

Gentamicin side effects

If you experience any of the following serious side effects, stop taking gentamicin and seek emergency medical attention:

  • an allergic reaction (shortness of breath; closing of the throat; hives; swelling of the lips, face, or tongue; rash; or fainting);

  • little or no urine;

  • decreased hearing or ringing in the ears;

  • dizziness, clumsiness, or unsteadiness;

  • numbness, skin tingling, muscle twitching, or seizures; or

  • severe watery diarrhea and abdominal cramps.

Other, less serious side effects may be more likely to occur. Continue to take gentamicin and talk to your doctor if you experience

  • increased thirst;

  • loss of appetite;

  • nausea or vomiting;

  • a rash.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Gentamicin dosing information

Usual Adult Dose for Bacteremia:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: 14 days, depending on the site, nature, and severity of the bacteremia

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Bacterial Endocarditis Prophylaxis:

1.5 mg/kg (maximum 120 mg) IV or IM once within 30 minutes of starting the procedure

Comments: For high risk patients, in addition to gentamicin, ampicillin 2 g is given IV or IM 30 minutes prior to the procedure, followed by ampicillin 1 g IV/IM or amoxicillin 1 g orally 6 hours later. In penicillin-allergic patients, vancomycin 1 g is infused IV 1 to 2 hours prior to the procedure.

Usual Adult Dose for Bacterial Infection:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours, or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: 7 to 21 days, depending on the nature and severity of the infection

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Brucellosis:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: For the first 2 to 3 weeks of antibiotic therapy

Comments: Oral doxycycline or sulfamethoxazole/trimethoprim should be continued for at least 6 weeks.

Usual Adult Dose for Burns - External:

2 to 2.5 mg/kg loading dose, followed by 1.7 to 2 mg/kg IV every 8 hours
Duration of therapy: 10 to 14 days, depending on the nature and severity of the infection

Usual Adult Dose for Cystic Fibrosis:

5 to 10 mg/kg/day in 2 to 4 divided doses
Duration of therapy: Parenteral therapy should be continued for about 14 to 21 days, depending on the nature and severity of the infection and improvement of pulmonary function.

Usual Adult Dose for Endocarditis:

American Heart Association (AHA) recommendations:
Native valve infections due to highly penicillin-susceptible viridans Group streptococci and S bovis (MIC <=0.12 mcg/mL): 3 mg/kg IV or IM once every 24 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 4 weeks

Native valve infections due to relatively penicillin-resistant S viridans and S bovis (MIC >0.12 mcg/mL and <=0.5 mcg/mL): 3 mg/kg IV or IM once every 24 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 4 weeks

Prosthetic valve infections due to S viridans and S bovis: 3 mg/kg IV or IM once every 24 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 6 weeks

Native valve infections due to staphylococci: 1.5 mg/kg IV or IM every 12 hours or 1 mg/kg every 8 hours, in combination with nafcillin, oxacillin, or cefazolin
Duration of therapy: 3 to 5 days; continue other antibiotic for 6 weeks

Prosthetic valve infections due to staphylococci: 1.5 mg/kg IV or IM every 12 hours or 1 mg/kg every 8 hours, in combination with nafcillin or oxacillin, plus rifampin, or vancomycin plus rifampin
Duration of therapy: 2 weeks; continue other antibiotics for at least 6 weeks

Native valve or prosthetic valve infections due to susceptible enterococci: 1 mg/kg IV or IM every 8 hours, in combination with ampicillin, aqueous penicillin G sodium, or vancomycin
Duration of therapy: 4 to 6 weeks; continue other antibiotic for 6 weeks

Native valve or prosthetic valve infections due to penicillin-resistant enterococci: 1 mg/kg IV or IM every 8 hours, in combination with ampicillin-sulbactam or vancomycin
Duration of therapy: 6 weeks

Comments: Refer to current published guidelines for detailed recommendations.

Usual Adult Dose for Endometritis:

2 mg/kg loading dose, followed by 1.5 mg/kg IV or IM every 8 hours
Duration of therapy: Parenteral therapy should be continued for at least 24 hours after the patient has remained afebrile, pain free, and the leukocyte count has normalized.

Usual Adult Dose for Febrile Neutropenia:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours
Duration of therapy: Once the patient is stable, afebrile for 24 hours, and the absolute neutrophil count is greater than 500/mm3, oral antibiotics may be substituted if antibiotic therapy is to be continued.

Usual Adult Dose for Intraabdominal Infection:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: 14 days, depending on the nature and severity of the infection

Comments: Less toxic antibiotics may be substituted once the patient is stable for at least 48 hours.

Usual Adult Dose for Meningitis:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours
Duration of therapy: Parenteral therapy should be continued for at least 1 week after the patient becomes afebrile and cerebrospinal fluid normalizes.

Usual Adult Dose for Osteomyelitis:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: 4 to 6 weeks, depending on the nature and severity of the infection; chronic osteomyelitis may require an additional 1 to 2 months of oral antibiotics

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Pelvic Inflammatory Disease:

2 mg/kg loading dose, followed by 1.5 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Parenteral therapy should be continued for at least 24 hours after clinical improvement and should be followed by oral doxycycline or clindamycin for a total 14 day course.

Usual Adult Dose for Peritonitis:

IV: 2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for about 14 days, depending on the nature and severity of the infection.

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Intraperitoneally in CAPD patients: 0.6 to 0.75 mg/kg intraperitoneally once a day or 16 to 20 mg per every 2 L dialysate

Usual Adult Dose for Plague:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for about 10 to 14 days, depending on the nature and severity of the infection.

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient's condition improves, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Pneumonia:

2 mg/kg loading dose, followed by 1.7 mg/kg IV or IM every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for 14 to 21 days, depending on the nature and severity of the infection.

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Pyelonephritis:

2 mg/kg loading dose, followed by 1.7 mg/kg IV every 8 hours or 5 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for about 7 to 14 days, depending on the nature and severity of the infection.

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Skin or Soft Tissue Infection:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for at least 10 to 14 days, or until 3 days postacute inflammation, depending on the nature and severity of the infection; for severe infections, such as diabetic soft tissue infections, 14 to 21 days of therapy may be required

Comments: Limiting the duration of gentamicin therapy may help limit toxicity. Once the patient is stable for at least 48 hours, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Adult Dose for Surgical Prophylaxis:

1.5 to 2 mg/kg (maximum 120 mg) IV or IM once at induction of anesthesia

Usual Adult Dose for Tularemia:

1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours or 5 to 7 mg/kg IV every 24 hours
Duration of therapy: Therapy should be continued for about 10 to 14 days, depending on the nature and severity of the infection.

Comments: Once the patient's condition improves, less toxic IV or oral antibiotic therapy may be considered according to microbiology sensitivity data.

Usual Pediatric Dose for Bacterial Infection:

0 to 4 weeks, birthweight <1200 g: 2.5 mg/kg IV or IM every 18 to 24 hours
0 to 1 week, birthweight >=1200 g: 2.5 mg/kg IV or IM every 12 hours
1 to 4 weeks, birthweight 1200 to 2000 g: 2.5 mg/kg IV or IM every 8 to 12 hours
1 to 4 weeks, birthweight >=2000 g: 2.5 mg/kg IV or IM every 8 hours

>1 month: 1 to 2.5 mg/kg IV or IM every 8 hours

Usual Pediatric Dose for Bacterial Endocarditis Prophylaxis:

1.5 mg/kg IV or IM once within 30 minutes of starting the procedure

Comments: For high risk patients, in addition to gentamicin, ampicillin 50 mg/kg (maximum 2 g) is given IV or IM 30 minutes prior to the procedure, followed by ampicillin 25 mg/kg IV/IM or amoxicillin 25 mg/kg orally 6 hours later. In penicillin-allergic patients, vancomycin 20 mg/kg IV is infused over 1 to 2 hours instead of ampicillin/amoxicillin.

Usual Pediatric Dose for Endocarditis:

AHA recommendations:
Native valve infections due to highly penicillin-susceptible viridans Group streptococci and S bovis (MIC <=0.12 mcg/mL): 3 mg/kg IV or IM once every 24 hours or 1 mg/kg every 8 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 4 weeks

Native valve infections due to relatively penicillin-resistant S viridans and S bovis (MIC >0.12 mcg/mL and <=0.5 mcg/mL): 3 mg/kg IV or IM once every 24 hours or 1 mg/kg every 8 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 4 weeks

Prosthetic valve infections due to S viridans and S bovis: 3 mg/kg IV or IM once every 24 hours or 1 mg/kg every 8 hours in combination with aqueous penicillin G sodium or ceftriaxone
Duration of therapy: 2 weeks; continue other antibiotic for 6 weeks

Native valve infections due to staphylococci: 1 mg/kg IV or IM every 8 hours, in combination with nafcillin, oxacillin, or cefazolin
Duration of therapy: 3 to 5 days; continue other antibiotic for 6 weeks

Prosthetic valve infections due to staphylococci: 1 mg/kg every 8 hours, in combination with nafcillin or oxacillin, plus rifampin, or vancomycin plus rifampin
Duration of therapy: 2 weeks; continue other antibiotics for at least 6 weeks

Native valve or prosthetic valve infections due to susceptible enterococci: 1 mg/kg IV or IM every 8 hours, in combination with ampicillin, aqueous penicillin G sodium, or vancomycin
Duration of therapy: 4 to 6 weeks; continue other antibiotic for 6 weeks

Native valve or prosthetic valve infections due to penicillin-resistant enterococci: 1 mg/kg IV or IM every 8 hours, in combination with ampicillin-sulbactam or vancomycin
Duration of therapy: 6 weeks

Comments: Refer to current published guidelines for detailed recommendations.

Usual Pediatric Dose for Surgical Prophylaxis:

2 mg/kg IV once at induction of anesthesia

What other drugs will affect gentamicin?

Other drugs, especially those that affect the kidneys, can interact with gentamicin resulting in dangerous side effects and/or decreased effectiveness. Do not take any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products, without first talking to your doctor during treatment with gentamicin.

Where can I get more information?

  • Your pharmacist has additional information about gentamicin written for health professionals that you may read.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.07. Revision Date: 2010-12-15, 5:01:39 PM.

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