Drug List Home Antibacterial Sensitivity Chart

Gentamicin

Dose Adult- NB; individualisation is critical because of its low therapeutic index

Usual dosage ranges: I.M., I.V.: Conventional: 1-2.5 mg/kg/dose every 8-12 hours; (75-150 mg / day)

To ensure adequate peak concentrations early in therapy, higher initial dosage may be considered

in selected patients when extracellular water is increased (edema, septic shock, postsurgical, or trauma)

Once daily: 4-7 mg/kg/dose once daily;

some clinicians recommend this approach for all patients with normal renal function;

this dose is at least as efficacious with similar, if not less, toxicity than conventional dosing

Intrathecal: 4-8 mg/day

Indication-specific dosing: I.M., I.V.:

Brucellosis: 240 mg (I.M.) daily or 5 mg/kg (I.V.) daily for 7 days; either regimen recommended in combination with doxycycline

Cholangitis: 4-6 mg/kg once daily with ampicillin

Diverticulitis (complicated): 1.5-2 mg/kg every 8 hours (with ampicillin and metronidazole)

Endocarditis: Treatment: 3 mg/kg/day in 1-3 divided doses

Meningitis Enterococcus sp or Pseudomonas aeruginosa:

I.V.: Loading dose 2 mg/kg, then 1.7 mg/kg/dose every 8 hours (administered with another bacteriocidal drug)

Pelvic inflammatory disease: Loading dose: 2 mg/kg, then 1.5 mg/kg every 8 hours

Alternate therapy: 4.5 mg/kg once daily

Plague ( Yersinia pestis ): Treatment: 5 mg/kg/day, followed by postexposure prophylaxis with doxycycline

Pneumonia, hospital- or ventilator-associated: 7 mg/kg/day (with antipseudomonal beta-lactam or carbapenem)

Synergy (for gram-positive infections): 3 mg/kg/day in 1-3 divided doses (with ampicillin)

Tularemia: 5 mg/kg/day divided every 8 hours for 1-2 weeks

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

Dosing: Pediatric

7.5mg/kg OD if >7days old.

Neonatal; <2kg=3mg/kg OD {=} >2kg 5mg/kg OD

Use of ideal body weight (IBW) for determining the mg/kg/dose appears to be more

accurate than dosing on the basis of total body weight (TBW).

In morbid obesity, dosage requirement may best be estimated using a dosing weight of IBW + 0.4 (TBW - IBW).

Initial and periodic plasma drug levels (eg, peak and trough with c

onventional dosing) should be determined, particularly in critically-ill patients with serious infections

or in disease states known to significantly alter aminoglycoside pharmacokinetics

(eg, cystic fibrosis, burns, or major surgery).

Usual dosage ranges: I.M., I.V.:

Infants and Children <5 years: 2.5 mg/kg/dose every 8 hours*

Children ≥5 years: 2-2.5 mg/kg/dose every 8 hours*

*Note: Higher individual doses and/or more frequent intervals (eg, every 6 hours)

may be required in selected clinical situations (cystic fibrosis) or serum levels document the need.

Indication-specific dosing:

Meningitis: Neonates: I.V.:

0-7 days of age: <2000 g: 2.5 mg/kg every 18-24 hours; >2000 g: 2.5 mg/kg every 12 hours

8-28 days of age: <2000 g: 2.5 mg/kg every 8-12 hours; >2000 g: 2.5 mg/kg every 8 hours

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