Clinical Pharmacology of Gentamicin

Abstract

Gentamicin is an important agent for the treatment of many serious gram-negative bacillary infections. Gentamicin is the aminoglycoside of first-choice because the reliable activity against all but the most resistant gram-negative aerobes. Gentamicin preparations are available for parenteral, ophthalmic, and topical administration. The recommended intramuscular or intravenous dose of gentamicin sulphate for treatment of gram-negative organisms in adults with normal renal function is 5 to 7 mg/kg daily. For patients with renal dysfunction the interval between may be extended. The efficacy and safety of gentamicin have been reported but gentamicin may induce nephrotoxicity and/or ototoxicity in some patients. Gentamicin penetrates in significant amounts into bone, skeletal muscle, wound tissue, ischemic foot ulcers, and in subcutaneous tissue. The pharmacokinetics of gentamicin have been studied in febrile neutropenic adult patients and in healthy adult subjects and gentamicin elimination half-life is about 3 hours. The pharmacokinetics of gentamicin have been investigated in tetraplegic and in paraplegic adult patients and in healthy adult subjects and the elimination half-life of gentamicin is about 2 hours. The prophylaxis, treatment, and trials with gentamicin have been extensively reported. Gentamicin penetrates into the cerebrospinal fluid in significant amounts and treats bacterial meningitis in infants. Gentamicin is poorly transferred across the human placenta and poorly migrates into the breast-milk. The aim of this study is to review gentamicin efficacy and safety, toxicity, diffusion into body-tissues, pharmacokinetics, prophylaxis, treatment, trials, penetration into the cerebrospinal fluid, treatment of bacterial meningitis, transfer across the human placenta, and migration into the breast-milk.