The drug is administered intramuscularly and intravenously.
Dosing for patients with normal renal function:
Usually the daily dose in adults with diseases of moderate severity is Zmg / kg, the frequency of administration is 2-3 times a day. In severe disease, the daily dose is 5 mg / kg, the frequency of administration 3-4 times a day; after improving the condition, the dose is reduced to 3 mg / kg / day. The maximum daily dose is 5 mg / kg.
Patients with infectious and inflammatory diseases of the urinary tract and normal kidney function are prescribed once a day at a dose of 120-160 mg for 7-10 days; with gonorrhea - 240-280 mg once. With a single intravenous injection of a daily dose of gentamicin, the administration time should be 30-60 minutes. When 2-3 times the introduction of gentamicin: its concentration in the serum before the next administration should not exceed 2 μg / ml, with a single administration - not more than 1 μg / ml. The average duration of treatment is 7-10 days.
Children from 1 month to 12 years administered intramuscularly or intravenously at a dose of 6 mg / kg / day in 1-3 doses.
Children over 12 years of age: intramuscularly or intravenously - 2-5 mg / kg / day in 1-3 administration. Prevention of postoperative infections of the abdominal cavity: with surgical intervention on the intestine, a single dose of gentamicin is administered in combination with metronidazole or clindamycin.
Dosage of gentamicin in patients with impaired renal function.
In renal failure, the gentamicin administration regimen is adjusted by reducing the dose or extending the intervals between administrations. In this case, a single dose of the drug for patients with a body weight above 60 kg is 1 mg / kg, less than 60 kg - 0.8 mg / kg.
To calculate the intervals between the administration of the drug to a patient with a violation of the excretory function of the kidneys, the following formula can be recommended: interval between administrations (in hours) = serum creatinine concentration (mg / 100 ml) x 8.
| Urea | Clearance creatinine | Whey creatinine | Doses and intervals between doses |
| mg / 100 ml | mmol / l | ml / min | ml / s | mg / 100 ml | tsmol / l |
|
| <40 | <6.8 | >70 | >1.16 | <1.4 | <124 | 80 mg * every 8 hours |
| 40-100 | 6.8-17 | 30-70 | 0.5-1.16 | 1.4-1.9 | 124-168 | 80 mg * every 12 hours |
| 1.9-2.8 | 168-248 | 80 mg * every 18 hours |
| 100-200 | 17-34 | 10-30 | 0.16-0.5 | 2.8-3.7 | 248-327 | 80 mg * every 24 hours |
| 3.7-5.3 | 327-469 | 80 mg * every 36 hours |
| >200 | >34 | 5-10 | 0.08-0.16 | 5.3-7.2 | 469-636 | 80 mg * every 48 hours |
* 60 mg, gentamicin, if the body weight is less than 60 kg.
Elderly patients, as well as with severe burn disease, need to determine the concentration of gentamicin in plasma for an adequate choice of dosing regimen.
In severe infections, the recommended use of smaller single doses with a higher multiplicity; the reduction in the single dose should be a multiple of the ratio of the interval calculated according to the above formula to the value of the normal interval between administrations (8 h).The dose should be selected so that Cmax does not exceed 12 μg / ml (reduced risk of developing nephro-, oto- and neurotoxicity).
With edema, ascites, obesity, the dose is determined by the "ideal" or "dry" mass of the body. In case of kidney failure and hemodialysis, the recommended dose after the adult session is -1-1.7 mg / kg (depending on the severity of the infection), children - 2-2.5 mg / kg. When intravenously administered gentamicin: the contents of the ampoule (1 or 2 ml solution for injection) should be dissolved in 100 ml or 200 ml of sterile saline or sterile 5% glucose solution. Concentration of gentamicin in the solution should not exceed 1 mg / ml. Enter intravenously drip for 30-60 minutes.