Gentamicin

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Gentamicin

Indication
  • Empirical antibiotic with vancomycin for line sepsis (review ongoing need when culture results are available)
  • All other indications as per NHS Lothian Antimicrobial guideline

Dosage and Administration
  • 2mg/kg
(Please use dry weight. This is particularly important in patients with oedema) **Do NOT use Gentamicin Calculator on the Intranet**
  • Please administer via a central venous catheter or a large vein if only peripheral access is available.

Concentration and Strength
  • 80mg/2ml or diluted for infusion

Stability
  • Please use reconstituted solution as soon as possible.

Reconstitution instructions
  • IV injection - to be administered over 5 minutes Can be given undiluted (40mg/ml) or diluted in 10-20ml of sodium chloride 0.9% or glucose 5% to aid slow bolus injection.
  • IV infusion - to be infused over 20 minutes Dilute in 100ml of sodium chloride 0.9% or glucose 5%

Additional Information
  • Haemodialysis (HD) removal: Yes
  • Haemodiafiltration (HDF) removal: Yes
  • Dose should be administered after dialysis

Monitoring
Inpatients Outpatients
Dialysis Days
  • Take a level pre-dialysis
  • Dose to be administered if level is <3mg/l
Non-dialysis days
  • Please take a level before the expected dosing time
  • Dose to be administered if level is <2mg/l
Peak level after dose administration
  • Take a peak level ONE HOUR AFTER the end of dose administration
  • Target peak is 8 to 12mg/l. Please discuss dose adjustment with Renal pharmacist if target not achieved
  • No further dose change is required when two therapeutic peak levels are achieved unless clinically indicated
  • Take a level pre-dialysis
  • Dose to be administered if level is <3mg/l
For NEW patients starting on gentamicin, a pre-dialysis level is not required prior to the first dose 
Written by: Dr Ailish Nimmo, Specialist Registrar, Renal Pharmacist
Reviewed by: Dr Iain MacIntyre, Consultant Nephrologist
Date written: January 2018
Review date: January 2020

 

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