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Therapeutic action
- Aminoglycoside antibacterial
Indications
- Severe bacterial infections: meningitis, pneumonia, pyelonephritis, postpartum upper genital tract infections, brucellosis, etc., in combination with other antibacterials
Forms and strengths, route of administration
- 80 mg ampoule (40 mg/ml, 2 ml) and 20 mg vial (10 mg/ml, 2 ml), for IM or slow IV injection (3 minutes) or IV infusion (30 minutes) in 0.9% sodium chloride or 5% glucose
Dosage
Meningitis in young children, in combination with ampicillin or cloxacillin
- Neonate:
- 0 to 7 days (< 2 kg): 3 mg/kg once daily by IV injection or infusion
- 0 to 7 days (≥ 2 kg): 5 mg/kg once daily by IV injection or infusion
- 8 days to < 1 month: 5 mg/kg once daily by IV injection or infusion
- Child 1 to 3 months: 2.5 mg/kg every 8 hours by IV injection or infusion
Other severe infections
- Neonate : as above
- Child 1 month and over and adult: 5 to 6 mg/kg once daily
For administration by IV infusion, dilute each dose of gentamicin in 5 ml/kg of 0.9% sodium chloride or 5% glucose in children less than 20 kg and in a bag of 100 ml of 0.9% sodium chloride or 5% glucose in children 20 kg and over and in adults.
Duration
- According to indication and clinical response. Given the risk of renal and auditory toxicity, do not prolong treatment unnecessarily.
Contra-indications, adverse effects, precautions
- Do not administer to patients with allergy to aminoglycosides or auditory and vestibular damage.
- Administer with caution and reduce dosage (1 mg/kg daily) in patients with renal impairment.
- May cause: renal impairment, irreversible auditory and vestibular damage, blockage of neuromuscular transmission, allergic reactions.
- Do not combine with another aminoglycoside.
- Monitor combination with: furosemide, amphotericin B, vancomycin (enhanced renal and/or auditory toxicity); neuromuscular blockers, general anaesthetics (potentialization of their effects).
- Pregnancy: administer only if clearly needed (risk of fetal ototoxicity).
- Breast-feeding: no contra-indication
Remarks
- Do not mix with other drugs in the same syringe or infusion.
- Gentamicin is also used in the treatment of plague in pregnant and breast-feeding women at a dose of 5 mg/kg once daily for 10 days.
Storage
– Below 25 °C