Gentamicin

Administer IV dose over 1 hour
Adjust dosing per kinetics if >1-2 days use
Aminoglycosides are associated with risk of Ototoxicity and nephrotoxicity (FDA black box warning)

See Bacterial Conjunctivitis
Adult
1. Gentamicin 3 to 5 mg/kg/day divided every 8 hours IV or IM (FDA approved) OR
2. Gentamicin 5 to 7 mg/kg/dose IV every 24 hours (off label)
Child (age >1 month old, weight >2 kg)
1. Gentamicin 2 to 2.5 mg/kg/dose IV or IM every 8 hours (FDA approved) OR
2. Gentamicin 5 to 7 mg/kg/dose IV every 24 hours (off label)
Obesity
1. Base dose on average between the Ideal Body Weight and actual weight

See other references for preterm and Low Birth Weight Infants
Term Infant (age <1 week, weight >2 kg)
1. Gentamicin 2.5 mg/kg/dose IV or IM every 8 hours (FDA approved) OR
2. Gentamicin 4 mg/kg IV every 24 hours (off-label)
Term Infant (age 8 to 28 days, weight >2 kg)
1. Gentamicin 2 to 2.5 mg/kg/dose IV or IM every 8 hours (FDA approved) OR
2. Gentamicin 4 to 5 mg/kg IV every 24 hours (off-label)

Target levels for multiple daily dosing
1. Maintain Trough <2 mcg/ml
  1. Drawn immediately before next dose
2. Maintain Peak at 5 to 8 mcg/ml in adults (4 to 6 mcg/ml for child)
  1. Draw 1 hour after Intramuscular dose
Target levels for once daily dosing
1. Maintain peak level 15 to 20 mcg/ml
2. Maintain trough level <1 mcg/ml
Indications for drug levels followed by Pharmacist
1. See Aminoglycoside for Nephrotoxicity Risk factors
2. Aminoglycoside use over 3 days
3. Renal dysfunction
4. Burn Injury

See Aminoglycoside
Aminoglycosides are associated with risk of Ototoxicity and nephrotoxicity (FDA black box warning)
1. See Aminoglycoside for risk factors