We rely on the aminoglycoside gentamicin for its rapid bactericidal and broad spectrum action against Gram negative aerobes like E. coli and Klebsiella species. It’s safety margin is increased in sepsis – the volume of distribution expands. Ototoxicity and nephrotoxocity is almost always due to cumulative effects of prolonged dosing and is minimised through use of once daily dosing (normal renal function) and short courses (maximum 3 daily doses in most circumstances). This HNE LHD 2014 Aminoglycoside_communique reflects current recommendations from Therapeutic Guidelines: Antibiotic,Australia.
For those patients receiving directed treatment, then please obtain advice from the Hunter Drug Information Service – see the reverse of the communique above. The TDM request sheet is reflected here- Aminoglycoside monitoring fax request.
Across HNE LHD, there is sustained gentamicin susceptibility amongst a majority of Gram negative clinical isolates making it the best aminoglycoside choice . However a proportion of extended spectrum betalactamase produces are resistant and this may increase – stay tuned for updates to our local antibiograms in December.