Gentamicin

=Gentamicin=

How it works
//Gentamicin binds irreversibly to bacterial ribosomes and inhibits protein synthesis. It has synergistic action when given with penicillin.//

Questions to Ask
What medications? //Loop diuretics, Non-depolarising muscle relaxants, Vancomycin, Amphotericin B, Indomethacin// - medical conditions? //renal impairment (dose adjustment necessary)// - allergies?

How to take
//IV - push over 5 minutes. IM – as per standard// __For infants **less than** 30 weeks gestation:__ __For infants **greater than or equal** to 30 weeks gestation:__ __For infants **greater than** 41 weeks post-conception:__ __For infants **greater than** 44 weeks post-conception:__
 * IV, IM: ** 3mg/kg daily
 * IV, IM: ** 3.5mg/kg daily
 * IV, IM: ** 5mg/kg daily
 * IV, IM: ** 8mg/kg daily

//Patients with CF may require increased doses// Consider that gentamicin requires monitoring. Risk factors include neonates with: - poor kidney function - gestational age <27 weeks __half-life:__ neonates: 2 to 12 hours, infants and older children: 1.5 to 3 hours __sampling times:__ 2 levels required. 1 hour and 6 hours post dose. Accurate documentation of dosing and timing of levels essential.
 * Monitoring**

Side effects
**Common:** non-oliguric renal impairment (increase in plasma urea and creatinine), ototoxicity
 * Rare:** oliguria, anaphylaxis, respiratory depression

Other advice?
Gentamicin is removed from the body by the kidneys. It has a larger volume of distribution in neonates than in adults as a result of the higher water to fat ratio. Gestational age has a strong correlation with half-life, which ranges from 6 to 10 hours in this population.

CMI
Neonatal Guidelines - Gentamicin