Category:

• Antibiotic

Description:

• Aminoglycoside antibiotic

Indications:

• Serious infections (P. aeruginosa, Proteus species, E. coli, Klebsiella species, Enterobacter species, Serratia species, Citrobacter species, Staphylococcus species)

• Bacterial neonatal sepsis

• Bacterial septicemia

• Serious bacterial infections of the CNS (meningitis)

• Urinary tract, respiratory tract, skin, bone and soft tissue (including burns) infections

• Gram-negative infections

• Emperic therapy for unknown serious infections

Contraindications:

• Generally not indicated for long-term therapy due to nephrotoxocity and ototoxicity

Precautions:

• Pregnancy category D

• May cause nephrotoxicity, therefore closely monitor renal function, especially in elderly patients.

• May cause ototoxicity, therefore monitor hearing

• Monitor peak and trough serum concentrations

• In patients with extensive burns, altered pharmacokinetics may alter serum concentrations.

• May produce hypomagnesemia, especially if poor or restricted diet.

• Aminoglycosides have neuromuscular blockade activity with a curare-like effect.  Monitor patient’s neuromuscular function, especially in patients with myasthenia gravis, parkinsonism or infant botulism.

Adverse Reactions (Side Effects):

• Central and peripheral nervous system reactions:

  • Headache

  • Depression

  • Confusion

  • Lethargy

  • Muscle twitching

  • Peripheral neuropathy

• Gastrointestinal: vomiting, nausea, anorexia, hypersalivation

• Hematologic: changes in reticulocyte counts, anemia, altered WBC counts

• Hypersensitivity: rash, urticaria, itching

• Special senses: dizziness, tinnitis, vertigo

• Renal: oliguria, proteinuria, increased creatinine and BUN

• Miscellaneous: apnea, alopecia, joint pain

• Pain at injection site

• Decreased calcium, sodium, potassium and magnesium levels  

Dosage:

• Administered by IM or IV injection

• Therapy duration is generally 7-10 days

• obese patients: 

  • base dose on lean body mass

• Children:

  • 6-7.5mg/kg/day (2-2.5mg/kg q8h)

• Infants and neonates

  • 7.5mg/kg/day (2.5mg/kg q8h)

• Premature or full term neonates (< 1 week of age):

  • 5mg/kg/day (2.5mgkg q12h)