Neofax 24th ed, 2011. Gentamicin p 50-52. UK NICE Guidelines August 2012.
Antibiotics for early-onset infection: Antibiotics for the prevention and treatment of
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ROYAL HOSPITAL FOR WOMEN
Approved by Neonatal Clinical Committee
CLINICAL POLICIES AND PROCEDURES NEWBORN USE ONLY GIVEN ON DOCTORS ORDER ONLY
GENTAMICIN DESCRIPTION
Aminoglycoside antibiotic.
USE
Gram negative infections. First line drug along with penicillin group in treating sepsis of unknown etiology.
PHARMACOKINETICS Variable absorption with IM injection. Distributes widely throughout the body, but negligible penetration into CSF. Excreted almost entirely by glomerular filtration. Serum half-life is prolonged in premature, asphyxiated newborns, significant PDA or on indomethacin. DOSE Corrected Gestational Age* 30 days 0-7 days 8 days and more All
30-34 wks
35-37 wks
Dose mg/kg
Interval
5 4 4 5 4
48 hours 36 hours 24 hours 36 hours 24 hours
4
24 hours
38 weeks and over
0-7 days 4 24 hours 8-28 days 5 24 hours *Corrected gestational age (wks) = gestational age (wks) at birth + postnatal age (wks) PRESENTATION
10mg/ml ampoule 2mg/ml pre-made syringe
RECONSTITUTION
Add 1ml (10mg) of gentamicin to 9ml of 0.9%sodium chloride to give a 1mg/ml solution.
OR Use pre-made syringe undiluted. ADMINISTRATION
IV infusion over 30 minutes using proximal IV bung. Administer as a separate infusion from penicillin-containing compounds.
NOTE
Ampicillin and Amoxicillin may degrade gentamicin when in the same blood sample tube causing a falsely low serum gentamicin concentration reading. Separate ampicillin and gentamicin administration by 2 hours or give ampicillin after gentamicin levels have been drawn.
MONITORING
Trough levels immediately prior to 2 dose. Further trough levels should th th be considered before every subsequent third dose (i.e. before 5 dose, 8 dose etc.). 0.5ml of blood is to be collected in green top plasma tube. The lab testing is available 24 hours a day and the result will be available within 1-2 hours. Results of the levels must be obtained and discussed with medical team prior to the administration.
nd
In renal disfunction trough level to be checked prior to each dose.
Revised by S Bolisetty
4.10.12
ROYAL HOSPITAL FOR WOMEN
Approved by Neonatal Clinical Committee
CLINICAL POLICIES AND PROCEDURES NEWBORN USE ONLY GIVEN ON DOCTORS ORDER ONLY Acceptable trough level for the first 3 doses:
