Gentamicin (as Gentamicin sulfate) 10 mg per 1 mlGentamicin
20 mg/ 2 ml solution for injection ampoules| 5 ampouleP£ 11. 25
Gentamicin Paediatric 20 mg/ 2 ml solution for injection vials|
5 vialP£ 11. 25 DT = £ 11. 25
Gentamicin (as Gentamicin sulfate) 40 mg per 1 mlGentamicin
80 mg/ 2 ml solution for injection vials| 5 vialP£ 20. 00 (Hospital
only)
Gentamicin 80 mg/ 2 ml solution for injection ampoules|
5 ampouleP£ 6. 88 | 10 ampouleP£ 10. 00
▶Cidomycin(Sanofi)
Gentamicin (as Gentamicin sulfate) 40 mg per 1 mlCidomycin
Adult Injectable 80 mg/ 2 ml solution for injection vials| 5 vialP
£ 6. 88
Cidomycin Adult Injectable 80 mg/ 2 ml solution for injection ampoules
| 5 ampouleP£ 6. 88
Infusion
▶Gentamicin (Non-proprietary)
Gentamicin (as Gentamicin sulfate) 1 mg per 1 mlGentamicin
80 mg/ 80 ml infusion bags| 20 bagP£ 40. 17
Gentamicin (as Gentamicin sulfate) 3 mg per 1 mlGentamicin
240 mg/ 80 ml infusion bags| 20 bagP£ 122. 57 – £ 122. 58
Gentamicin 360 mg/ 120 ml infusion bags| 20 bagP£ 174. 07eiiiiF 311Streptomycin
lINDICATIONS AND DOSE
Tuberculosis, resistant to other treatment, in combination
with other drugs
▶BY DEEP INTRAMUSCULAR INJECTION
▶Child: 15 mg/kg once daily (max. per dose 1 g)
Adjunct to doxycycline in brucellosis (administered on
expert advice)
▶BY DEEP INTRAMUSCULAR INJECTION
▶Child: 5 – 10 mg/kg every 6 hours, total daily dose may
alternatively be given in 2 – 3 divided doseslUNLICENSED USENot licensed for use in children.
IMPORTANT SAFETY INFORMATION
Side-effects increase after a cumulative dose of 100 g,
which should only be exceeded in exceptional
circumstances.lINTERACTIONS→Appendix 1 : aminoglycosides
lSIDE-EFFECTSHypersensitivity.oral paraesthesia
lRENAL IMPAIRMENT
Dose adjustmentsShould preferably be avoided. If
essential, use with great care and consider dose reduction.
lMONITORING REQUIREMENTS
▶One-hour (‘peak’) concentration should be 15 – 40 mg/litre;
pre-dose (‘trough’) concentration should be less than
5 mg/litre (less than 1 mg/litre in renal impairment).
lMEDICINAL FORMS
Forms available from special-order manufacturers include:
powder for solution for injection
eiiiiF 311Tobramycin 28-Nov-2016
lINDICATIONS AND DOSE
ChronicPseudomonas aeruginosainfection in patients
with cystic fibrosis
▶BY INHALATION OF NEBULISED SOLUTION
▶Child 6–17 years: 300 mg every 12 hours for 28 days,
subsequent courses repeated after 28 -day interval
without tobramycin nebuliser solution
▶BY INHALATION OF POWDER
▶Child 6–17 years: 112 mg every 12 hours for 28 days,
subsequent courses repeated after 28 -day interval
without tobramycin inhalation powderPseudomonal lung infection in cystic fibrosis
▶BY SLOW INTRAVENOUS INJECTION
▶Child: 8 – 10 mg/kg daily in 3 divided doses, to be given
as a multiple daily dose regimen over 3 – 5 minutes
▶BY INTRAVENOUS INFUSION
▶Child:Initially 10 mg/kg once daily (max. per dose
660 mg), to be given over 30 minutes, subsequent
doses adjusted according to serum-tobramycin
concentration
Septicaemia|Meningitis and other CNS infections|Biliary-
tract infection|Acute pyelonephritis|Pneumonia in
hospital patients
▶BY SLOW INTRAVENOUS INJECTION
▶Child 1 month–11 years: 2 – 2. 5 mg/kg every 8 hours, to be
given as a multiple daily dose regimen over
3 – 5 minutes
▶Child 12–17 years: 1 mg/kg every 8 hours, to be given as a
multiple daily dose regimen over 3 – 5 minutes;
increased if necessary up to 5 mg/kg daily in
3 – 4 divided doses, to be given in severe infections as a
multiple daily dose regimen over 3 – 5 minutes, dose to
be reduced back to 3 mg/kg as soon as clinically
indicated
▶BY INTRAVENOUS INFUSION
▶Child:Initially 7 mg/kg, to be given as a once daily dose
regimen, subsequent doses adjusted according to
serum-tobramycin concentration
Neonatal sepsis
▶BY INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION
▶Neonate up to 32 weeks corrected gestational
age: 4 – 5 mg/kg every 36 hours, to be given as an
extended interval dose regimen, intravenous injection
to be given over 3 – 5 minutes.▶Neonate 32 weeks corrected gestational age and
above: 4 – 5 mg/kg every 24 hours, to be given as an
extended interval dose regimen, intravenous injection
to be given over 3 – 5 minutes.▶BY SLOW INTRAVENOUS INJECTION, OR BY INTRAVENOUS
INFUSION
▶Neonate up to 7 days: 2 mg/kg every 12 hours, to be given
as a multiple daily dose regimen.▶Neonate 7 days to 28 days: 2 – 2. 5 mg/kg every 8 hours, to
be given as a multiple daily dose regimen.DOSESATEXTREMESOFBODY-WEIGHT
▶To avoid excessive dosage in obese patients, use ideal
weight for height to calculate parenteral dose and
monitor serum-tobramycin concentration closely.
VANTOBRA®NEBULISER SOLUTION
Chronic pulmonaryPseudomonas aeruginosainfection in
patients with cystic fibrosis
▶BY INHALATION OF NEBULISED SOLUTION
▶Child 6–17 years: 170 mg every 12 hours for 28 days,
subsequent courses repeated after 28 -day interval
without tobramycin nebuliser solutionlCAUTIONS
▶When used by inhalationconditions characterised by
muscular weakness—may impair neuromuscular
transmission.history of prolonged previous or
concomitant intravenous aminoglycosides—increased risk
of ototoxicity.renal impairment—limited information
available.severe haemoptysis—risk of further
haemorrhage
lINTERACTIONS→Appendix 1 : aminoglycosidesBNFC 2018 – 2019 Bacterial infection 313
Infection5