Gentamicin

KEY POINTS

• Gentamicin is an aminoglycoside antibiotic that inhibits bacterial growth in susceptible organisms by interfering with bacterial protein synthesis
  • Binds to 30S and 50S ribosomal subunits, resulting in a defective bacterial cell membrane
  • Exhibit concentration-dependent bacterial killing (higher peak levels means more bacterial killing)
  • Has activity against many organisms, including susceptible Pseudomonas aeruginosa and Acinetobacter baumannii
• May be given via the intravenous, intrathecal, ophthalmic or topical
• Dosing is similar to tobramycin, while amikacin doses are typically larger than gentamicin or tobramycin doses on a mg/kg basis
• Use of extended-interval IV doses is generally more favorable towards reducing toxicity and maximizing efficacy
  • Adjust IV gentamicin doses & frequency for kidney impairment
  • Monitoring drug levels may be indicated
  • Nephrotoxicity and ototoxicity are potential side effects of IV therapy
  • See below resources for more on dosing/monitoring

RESOURCES

• Gentamicin IV Package Insert
• Nebraska Stewardship Program PK Training Content
• University Of Miami/ Jackson Memorial Hospital Dosing Guide
• Basics Of Pharmacokinetics & Pharmacodynamics
• PK-PD Compass
• IDSA Practice Guidelines
• Surgical Prophylaxis Guidelines