Aminoglycoside·Infectious Diseases - Aminoglycosides

Gentamicin

Severe gram-negative sepsis, pyelonephritis, endocarditis synergy, intra-abdominal sepsis

AMINOGLYCOSIDEDBL GentamicinS4TGA

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

7 mg/kg/day

Half-life

2-3 h

High risk: Nephrotoxic

CRITICAL

High risk: Ototoxic

CRITICAL

Cautions

Avoid / Cautions

Myasthenia gravis, pre-existing significant hearing loss. Pregnancy Category D. Causes irreversible congenital deafness.

Where it stands

Rapid Summary

Overview

Incredibly potent, rapid-acting bactericidal aminoglycoside. Devastates gram-negative aerobes (including Pseudomonas). Exhibits unique 'concentration-dependent' killing.

Clinical Focus

Narrow therapeutic index. Permanently destroys hearing and kidneys if blood levels are not aggressively monitored.

Bottom Line

Gentamicin is a potent aminoglycoside for serious gram-negative infections and synergistic endocarditis therapy, but has critical nephrotoxicity and irreversible ototoxicity requiring therapeutic drug monitoring.

Formulation & Access

Brand Names

DBL Gentamicin

Parenteral

Ampoules (80 mg/2 mL) for IV infusion.

Prescribing & PBS

Hospital supply.

Indications & Use

Primary

TGA

Severe gram-negative sepsis, pyelonephritis, endocarditis synergy, intra-abdominal sepsis.

Clinical Place

Often used as a single STAT dose in ED to rapidly sterilize the blood, followed by a safer beta-lactam.

Quick reference

Class & Role

Aminoglycoside — Incredibly potent, rapid-acting bactericidal aminoglycoside.

Route / Formulation

Ampoules (80 mg/2 mL) for IV infusion. (DBL Gentamicin)

Usual Dose & Max

IV 4-7 mg/kg OD (Once daily dosing maximizes peak killing while allowing troughs to drop to zero, saving the kidneys). Max 7 mg/kg/day (strictly based on Ideal Body Weight).

Key Indication Doses

Empiric Sepsis: IV 4-7 mg/kg OD (Once daily dosing maximizes peak killing while allowing troughs to drop to zero, saving the kidneys). Endocarditis Synergy: IV 1 mg/kg q8h (Targeting different peak/trough kinetics, specialist only). Renal Impairment: If eGFR is reduced, increase the interval (e.g., give every 36h or 48h) to allow the drug to wash out.

Best Uses

Key Risks

Renal: Acute tubular necrosis (AKI). Usually reversible if caught early. Neurological: Vestibulocochlear toxicity. Causes permanent, irreversible deafness and severe vertigo by destroying hair cells in the inner ear. Neuromuscular: Can block neuromuscular transmission, worsening Myasthenia Gravis or deepening surgical blockade.

Key Interactions

Vancomycin, Frusemide, NSAIDs, contrast dye. Co-administration guarantees synergistic nephrotoxicity and ototoxicity.

Monitoring

TDM (Therapeutic Drug Monitoring). Trough levels MUST be checked before the 2nd or 3rd dose. Trough must be < 1.0 mg/L to prevent toxicity. Daily U&E is mandatory. Ask patient daily about tinnitus, ringing in the ears, or dizziness. Stop drug immediately if present.

Clinical Pearl

Gentamicin causes kidney damage not from the massive peak dose, but from a persistent high trough. The kidneys need 12 hours of 'zero drug' to recover. If the trough is > 1.0, you must delay the next dose.

Access

DBL Gentamicin

Brand: DBL Gentamicin

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Aminoglycoside·Infectious Diseases - Aminoglycosides

Gentamicin

Severe gram-negative sepsis, pyelonephritis, endocarditis synergy, intra-abdominal sepsis

AMINOGLYCOSIDEDBL GentamicinS4TGA

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

7 mg/kg/day

Half-life

2-3 h

High risk: Nephrotoxic

CRITICAL

High risk: Ototoxic

CRITICAL

Cautions

Avoid / Cautions

Myasthenia gravis, pre-existing significant hearing loss. Pregnancy Category D. Causes irreversible congenital deafness.

Where it stands

Rapid Summary

Overview

Incredibly potent, rapid-acting bactericidal aminoglycoside. Devastates gram-negative aerobes (including Pseudomonas). Exhibits unique 'concentration-dependent' killing.

Clinical Focus

Narrow therapeutic index. Permanently destroys hearing and kidneys if blood levels are not aggressively monitored.

Bottom Line

Formulation & Access

Brand Names

DBL Gentamicin

Parenteral

Ampoules (80 mg/2 mL) for IV infusion.

Prescribing & PBS

Hospital supply.

Indications & Use

Primary

TGA

Severe gram-negative sepsis, pyelonephritis, endocarditis synergy, intra-abdominal sepsis.

Clinical Place

Often used as a single STAT dose in ED to rapidly sterilize the blood, followed by a safer beta-lactam.

Quick reference

Class & Role

Aminoglycoside — Incredibly potent, rapid-acting bactericidal aminoglycoside.

Route / Formulation

Ampoules (80 mg/2 mL) for IV infusion. (DBL Gentamicin)

Usual Dose & Max

IV 4-7 mg/kg OD (Once daily dosing maximizes peak killing while allowing troughs to drop to zero, saving the kidneys). Max 7 mg/kg/day (strictly based on Ideal Body Weight).

Key Indication Doses

Best Uses

Key Risks

Key Interactions

Vancomycin, Frusemide, NSAIDs, contrast dye. Co-administration guarantees synergistic nephrotoxicity and ototoxicity.

Monitoring

Clinical Pearl

Access

DBL Gentamicin

Brand: DBL Gentamicin

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.