Gentamicin sulfate
Gentamicin sulfate (Garamycin)
Gentamicin sulfate
(jen-tah- MY-sin)
Pregnancy Category: C Alcomicin Cidomycin Diogent Garamycin Garamycin Cream or Ointment Garamycin IV Piggyback Garamycin Ophthalmic Ointment Garamycin Ophthalmic Solution Garatec Genoptic Ophthalmic Liquifilm Genoptic S.O.P. Ophthalmic Gentacidin Ophthalmic Gentafair Gentak Ophthalmic Gentamicin Gentamicin Ophthalmic Gentamicin Sulfate IV Piggyback Gentrasul Ophthalmic G-myticin Cream or Ointment Minims Gentamcin Ocugram Ophtagram Pediatric Gentamicin Sulfate PMS-Gentamicin Sulfate Schwinpharm Gentamicin (Rx)

Classification: Antibiotic, aminoglycoside

See Also: See also Aminoglycosides .

Action/Kinetics: Therapeutic serum levels: IM, 4-8 mcg/mL. Toxic serum levels: >12 mcg/mL (peak) and >2 mcg/mL (trough). Prolonged serum levels above 12 mcg/mL should be avoided. t 1/2: 2 hr. Can be used with carbenicillin to treat serious Pseudomonas infections; do not mix these drugs in the same flask as carbenicillin will inactivate gentamicin.

Uses: Systemic: Serious infections caused by Pseudomonas aeruginosa, Proteus, Klebsiella, Enterobacter, Serratia, Citrobacter and Staphylococcus. Infections include bacterial neonatal sepsis, bacterial septicemia, and serious infections of the skin, bone, soft tissue (including burns), urinary tract, GI tract (including peritonitis), and CNS (including meningitis). Should be considered as initial therapy in suspected or confirmed gram-negative infections. In combination with carbenicillin for treating life-threatening infections due to P. aeruginosa. In combination with penicillin for treating endocarditis caused by group D streptococci. In combination with penicillin for treating suspected bacterial sepsis or staphylococcal pneumonia in the neonate. Intrathecal administration is used in combination with systemic gentamicin for treating meningitis, ventriculitis, or other serious CNS infections due to Pseudomonas. Investigational: Pelvic inflammatory disease.
Ophthalmic: Ophthalmic infections due to Staphylococcus, S. aureus, Streptococcus pneumoniae beta-hemolytic streptococci, Corynebacterium species, Streptococcus pyogenes, Escherichia coli, Haemophilus influenzae, H. aegyptius, H. ducreyi, Klebsiella pneumoniae, Neisseria gonorrhoeae, Proteus species, Acinetobacter calcoaceticus, Enterobacter aerogenes, P. aeruginosa, Serratia marcescens, Moraxella lacunata.
Topical: Prevention of infections following minor cuts, wounds, burns, and skin abrasions. Treatment of primary or secondary skin infections. Treatment of infected skin cysts and other skin abscesses when preceded by incision and drainage to permit adequate contact between the drug and the infecting bacteria, infected stasis and other skin ulcers, infected superficial burns, paronychia, infected insect bites and stings, infected lacerations and abrasions and wounds from minor surgery.

Contraindications: Ophthalmic use to treat dendritic keratitis, vaccinia, varicella, mycobacterial infections of the eye, fungal diseases of the eye, use with steroids after uncomplicated removal of a corneal foreign body.

Special Concerns: Use with caution in premature infants and neonates. Ophthalmic ointments may retard corneal epithelial healing.

Additional Side Effects: Muscle twitching, numbness, seizures increased BP, alopecia, purpura, pseudotumor cerebri. Photosensitivity when used topically. After ophthalmic use: Transient irritation, burning, stinging, itching, inflammation, angioneurotic edema, urticaria, vesicular and maculopapular dermatitis, mydriasis, conjunctival paresthesia, conjunctival hyperemia, nonspecific conjunctivitis, conjunctival epithelial defects, lid itching and swelling, bacterial/fungal corneal ulcers.

Additional Drug Interactions: With carbenicillin or ticarcillin, gentamicin may result in increased effect when used for Pseudomonas infections.

How Supplied: Cream: 0.1%; Injection: 10 mg/mL, 40 mg/mL; Ointment: 1%; Ophthalmic ointment: 3 mg/g; Ophthalmic Solution: 3 mg/mL

Dosage
?IM (usual), IV
Adults with normal renal function.
Infections.
1 mg/kg q 8 hr, up to 5 mg/kg/day in life-threatening infections; children: 2-2.5 mg/kg q 8 hr; infants and neonates: 2.5 mg/kg q 8 hr; premature infants or neonates less than 1 week of age: 2.5 mg/kg q 12 hr. Therapy may be required for 7-10 days.
Prevention of bacterial endocarditis, dental or respiratory tract procedures.
Adults: 1.5 mg/kg gentamicin (not to exceed 80 mg) plus 1 g ampicillin, each IM or IV, 30-60 min before the procedure; one additional dose of each can be given 8 hr later (alternative: penicillin V, 1 g PO, 6 hr after initial dose).
Prophylaxis of bacterial endocarditis in GI or GU tract procedures or surgery.
Adults: 1.5 mg/kg gentamicin (not to exceed 80 mg) plus 2 g ampicillin, each IM or IV, 30-60 min before procedure; dose should be repeated 8 hr later. Children: 2 mg/kg gentamicin plus penicillin G, 30,000 units/kg, or ampicillin, 50 mg/kg in same dosage interval as for adults. Pediatric dosage should not exceed single or 24-hr adult doses.
NOTE: In clients allergic to penicillin, vancomycin, 1 g IV given slowly over 1 hr, may be substituted; the dose of vancomycin should be repeated 8-12 hr later. Adults with impaired renal function: To calculate interval (hr) between doses, multiply serum creatinine level (mg/100 mL) by 8.
?IV Septicemia.
Initially: 1-2 mg/kg infused over 30-60 min; then, maintenance doses may be administered.
?Intrathecal Meningitis.
Use only the intrathecal preparation. Adults, usual: 4-8 mg/day; children and infants 3 months and older: 1-2 mg/day
Pelvic inflammatory disease.
Initial: 2 mg/kg IV; then, 1.5 mg/kg t.i.d. plus clindamycin, 500 mg IV q.i.d. Continue for at least 4 days and at least 48 hr after client improves. Continue clindamycin, 450 mg PO q.i.d. for 10-14 days.
?Ophthalmic Solution (0.3%) Acute infections.
Initially: 1-2 gtt in conjunctival sac q 15-30 min; then, as infection improves, reduce frequency.
Moderate infections.
1-2 gtt in conjunctival sac 4-6 times/day.
Trachoma.
2 gtt in each eye b.i.d.-q.i.d.; treatment should be continued for up to 1-2 months.
?Ophthalmic Ointment (0.3%)
Depending on the severity of infection, 1/2-in. ribbon from q 3-4 hr to 2-3 times/day.
?Topical Cream/Ointment (0.1%)
Apply 3-4 times/day to affected area. The area may be covered with a sterile bandage.