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Gentamicin is toxic to cochlear hair cells, and it is known to disrupt mitochondrial protein synthesis, which leads to increased oxygen free radical generation via inducible nitric oxide synthase activity. Please note that the maximum dose in patients >65 years of age, regardless of renal function, is 3mg/kg.
Name | Starting Dose | Frequency | Route |
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Gentamicin (Standard Indications*) | 5-7 mg/kg/day with Trough < 2 mg/litre. | once daily or less dose regimen | IV |
Gentamicin (Standard indications*) | 3-5 mg/kg/day | 8 hourly multiple daily dose regimen | IV |
Gentamicin (Enterococcal Endocarditis) | 1 mg/kg | 8-12 hourly | IV |
Gentamicin (Streptococcal Endocarditis) | 3 mg/kg | 24 hourly | IV |
Gentamicin (Gram positive/HACEK Endocarditis) | 1 mg/kg | 12 hourly | IV |
Gentamicin (Acute pyelonephritis (once daily dose regimen), Urinary tract infection (catheter-associated, once daily dose regimen)) | 5-7 mg/kg/day | Once daily dosing regimen | IV |
CrCl (ml/min) | Under 40 kg | 40-49 kg | 50-59 kg | 60-69 kg | 70-79 kg | Over 80 kg |
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<21 | 2.5 mg/kg (max 180 mg) then take a sample after 24 hours | |||||
21-30 | Give 5 mg/kg | 180 mg every 48 hrs | 200 mg every 48 hrs | 240 mg every 48 hrs | 240 mg every 48 hrs | 260 mg every 48 hrs |
31-40 | Give 5 mg/kg | 200 mg every 48 hrs | 240 mg every 48 hrs | 280 mg every 48 hrs | 300 mg every 48 hrs | 320 mg every 48 hrs |
41-50 | Give 5 mg/kg | 240 mg every 48 hrs | 280 mg every 48 hrs | 320 mg every 48 hrs | 360 mg every 48 hrs | 400 mg every 48 hrs |
51-60 | Give 5 mg/kg | 200 mg every 24 hrs | 240 mg every 24 hrs | 280 mg every 24 hrs | 300 mg every 24 hrs | 320 mg every 24 hrs |
Over 60 | Give 5 mg/kg | 240 mg every 24 hrs | 280 mg every 24 hrs | 320 mg every 24 hrs | 360 mg every 24 hrs | 400 mg every 24 hrs |