| 💉 Gentamicin (OD dosing protocol) |
| 1 |
⚖️ Determine weight
– Use Ideal Body Weight (IBW) if BMI >30 (gentamicin does not distribute into adipose).
– Treatment course should not exceed 7 days without microbiology advice.
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| 2 |
🧪 Estimate Creatinine Clearance (CrCl)
(140 – age) × weight (kg) × 1.23 (men)
(140 – age) × weight (kg) × 1.04 (women)
⚠️ Use IBW if obese.
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| 3 |
💊 Dosing (round down to nearest 40 mg):
- CrCl >30 mL/min → 5 mg/kg (max 480 mg/day)
- CrCl <30 mL/min → 3 mg/kg (max 320 mg/day)
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| 4 |
🧬 Monitor trough level (24 h after 1st dose):
- If <65 yrs, good urine output & normal renal function → give 2nd dose after sampling (don’t need result first).
- Otherwise → wait for result.
✅ Trough must be ≤1 mg/L before re-dosing.
- If elevated → repeat levels at 12–24 h; may need to extend interval to 36–48 h.
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| 5 |
⚠️ Do not prescribe in advance:
– Never write up “48-hourly gentamicin” → risk of being given 24-hourly in error.
– Prescribe on a daily review basis only.
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| 6 |
💧 Administration:
Infuse in 100 mL 0.9% sodium chloride over 30 minutes.
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