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

• Unlabeled use:

  • multi-drug regimen for Mycobacterium avium complex 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.

• Administer over 30-60 minute infusion

Adverse Reactions (Side Effects):

• Renal: oliguria, proteinuria, increased creatinine and BUN

• Miscellaneous: apnea

• Pain at injection site

• Granular casts

• “Malabsorption syndrome” characterized by increase in fetal fat, decrease in serum carotene and fall in xylose absorption

Dosage:

• Administered by IM or IV injection

• Do not exceed 1.5 grams per day by any route

• Adults:

  • 1.5mg/kg/day divided into 2-3 equal doses

• Aerosol treatment:

  • 250mg 2-4 times a day, diluted with 3mL of normal saline

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Medicine
 Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
  January 1, 2001