Gentamicin
Mechanism of Action
Binds irreversibly to the 30S ribosomal subunit, inhibiting protein synthesis and causing bacterial cell death. Concentration-dependent bactericidal effect.
Indications
- Severe Gram-negative infections (Pseudomonas, Enterobacter, Klebsiella, E. coli)
- Sepsis
- Complicated urinary tract infections
- Respiratory tract infections (hospital-acquired pneumonia)
- Bone and soft tissue infections
- Endocarditis (in combination therapy)
Dose
- Adults: 3–5 mg/kg/day IV/IM divided every 8 hours or once-daily extended interval dosing
- Children: 7.5 mg/kg/day IV/IM in divided doses every 8 hours
- Adjust dose in renal impairment
Major Side Effects
- Nephrotoxicity (acute tubular necrosis)
- Ototoxicity (hearing loss, vestibular toxicity)
- Neuromuscular blockade (rare)
- Rash, fever
Contraindications
- Hypersensitivity to aminoglycosides
- Myasthenia gravis (risk of neuromuscular blockade)
Compatible Fluid
- 0.9% Sodium chloride (normal saline)
- 5% Dextrose (D5W)
Route of Administration
Intravenous (IV) or Intramuscular (IM)
Type of Administration
Parenteral injection (IV/IM)