Indication for Use:
1. Infection with culture-proved organism sensitive to
aminoglycosides and not susceptible to a less-toxic agent.
2. Presumed infection in patients with clinical
possibility of gram-negative organisms. (Lab studies should document)
3. Prophylaxis in surgery — not to exceed 12 hours
before or 24 hours after procedure, where gram-negative infection is a
possibility.
4. Combination therapy in granulocytopenic patients.
Dose:
Loading dose of 1.5 - 2.5 mg/kg based on approximate ideal
body weight (IBW +40% (TBW-IBW) in obese patients) AND maintenance dosage range
of 3-5 mg/kg/day ideal weight — all rounded off to the nearest 10 mg. Adjust
dosage for decreased renal function or for significant renal function changes.
Pharmacokinetics consult recommended in patients with
abnormal renal function, excessive volume of distribution, or critically ill.
Monitor:
Serum creatinine obtained before therapy or within 24 hours
of initiation of therapy.
Serum creatinine obtained twice weekly during therapy. If
>2mg/dl then every other day.
Blood levels — peak and trough — if patient treated for
longer than 72 hours. If dose adjusted — draw levels again in 48 hr. —
repeat every 4-7 days.
Adverse Reactions — decreased renal function,
ototoxicity, hypersensitivity.
Outcome:
Clinical improvement noted in progress notes
Defervesence within 72 hours.
