Drug information of Gentamicin

Gentamicin

Drug group: Aminoglycosides

Gentamicin is an antibiotic that fights bacteria. Gentamicin is used to treat severe or serious bacterial infections.

Mechanism of effect

Aminoglycosides like gentamicin "irreversibly" bind to specific 30S-subunit proteins and 16S rRNA. Specifically gentamicin binds to four nucleotides of 16S rRNA and a single amino acid of protein S12. This interferes with decoding site in the vicinity of nucleotide 1400 in 16S rRNA of 30S subunit. This region interacts with the wobble base in the anticodon of tRNA. This leads to interference with the initiation complex, misreading of mRNA so incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides and the breakup of polysomes into nonfunctional monosomes.

Pharmacodynamic

Gentamicin is a broad spectrum aminoglycoside antibiotic. Aminoglycosides work by binding to the bacterial 30S ribosomal subunit, causing misreading of t-RNA, leaving the bacterium unable to synthesize proteins vital to its growth. Protein binding: Low (between 0 and 30%). Half life: 3-3½ hours in infants one week to six months of age; this increases to 5½ hours in full-term and large premature infants less than one week old.

Pharmacokinetics

Injections lead to peak serum concentrations in 30-60 minutes. Topical gentamicin is readily absorbed from large burned, denuded, or granulating areas but not through intact skin. Absorption of gentamicin is faster and greater with the cream compared to the ointment. Gentamicin is absorbed in small quantities following topical application to the eye. Gentamicin is also absorbed in small amounts following topical application to the ear (especially if the eardrum is perforated or if tissue damage is present). Gentamicin is very poorly absorbed orally.

Dosage

Usual Adult Dose for Bacterial Infection 1.5 to 2 mg/kg loading dose, followed by 1 to 1.7 mg/kg IV or IM every 8 hours, or 5 to 7 mg/kg IV every 24 hours Duration of therapy: 7 to 21 days, depending on the nature and severity of the infection Usual Pediatric Dose for Bacterial Infection 0 to 4 weeks, birthweight <1200 g: 2.5 mg/kg IV or IM every 18 to 24 hours 0 to 1 week, birthweight >=1200 g: 2.5 mg/kg IV or IM every 12 hours 1 to 4 weeks, birthweight 1200 to 2000 g: 2.5 mg/kg IV or IM every 8 to 12 hours 1 to 4 weeks, birthweight >=2000 g: 2.5 mg/kg IV or IM every 8 hours >1 month: 1 to 2.5 mg/kg IV or IM every 8 hours

Alerts

1-Patients treated with aminoglycosides should be under close clinical observation because of the potential toxicity associated with their use. 2-As with other aminoglycosides, gentamicin sulfate is potentially nephrotoxic. The risk of nephrotoxicity is greater in patients with impaired renal function and in those who receive high dosage or prolonged therapy. 3-Neurotoxicity manifested by ototoxicity, both vestibular and auditory, can occur in patients treated with gentamicin sulfate.

Points of recommendation

Patients should be counseled that antibacterial drugs including Gentamicin Sulfate in 0.9% Sodium Chloride Injection should only be used to treat bacterial infections. They do not treat viral infections (e.g., the common cold). 2-the medication should be taken exactly as directed. Skipping doses or not completing the full course of therapy may decrease the effectiveness of the immediate treatment and increase the likelihood that bacteria will develop resistance and will not be treatable by Gentamicin Sulfate in 0.9% Sodium Chloride Injection or other antibacterial drugs in the future.

Pregnancy level

D


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