Gentamicin - instructions for use, reviews, analogs and formulations (0.1% ointment, eye drops 0.3% Dex, injections in ampoules for injection in solution, tablets) medications for the treatment of infections in adults, children and pregnancy

In this article, you can read the instructions for using the drug Gentamicin. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors specialists on the use of antibiotic Gentamycin in their practice are presented. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Gentamicin in the presence of existing structural analogues. Use to treat infections in adults, children,as well as during pregnancy and lactation.

Gentamicin - an antibiotic of a group of aminoglycosides of a wide spectrum of action. Has a bactericidal effect. Actively penetrating the cell membrane of bacteria, inhibits the synthesis of the protein of the pathogen.

Highly active against aerobic Gram-negative bacteria: Escherichia coli, Shigella spp., Salmonella spp., Enterobacter spp., Klebsiella spp., Serratia spp., Proteus spp., Pseudomonas aeruginosa, Acinetobacter spp.

It is also active against aerobic Gram-positive cocci: Staphylococcus spp. (including those resistant to penicillins and other antibiotics), some strains of Streptococcus spp.

Gentamicin is resistant to Neisseria meningitidis, Treponema pallidum, some strains of Streptococcus spp., Anaerobic bacteria.

Dexamethasone is a synthetic glucocorticosteroid (SCS), whose anti-inflammatory and antiallergic effect is 25 times greater than the action of cortisol, which is a natural endogenous SCS. Possible penetration of Dexamethasone through the cornea with intact epithelium into the moisture of the anterior chamber of the eye; However, in the case of an inflammatory process or epithelial damage, the rate of penetration of dexamethasone through the cornea significantly increases.

Composition

Gentamicin (in the form of sulfate) + auxiliary substances.

Dexamethasone sodium phosphate + Gentamycin sulfate + excipients (Dexa drops and ophthalmic ointment).

Pharmacokinetics

After intramuscular injection, it is rapidly absorbed from the injection site. Binding to plasma proteins is low (0-10%). It is distributed in the extracellular fluid, in all tissues of the body. Penetrates through the placental barrier. It is not metabolized. 70-95% is excreted in the urine, a small amount with bile.

Indications

• Infectious-inflammatory diseases caused by microorganisms sensitive to gentamicin;
• for parenteral administration: acute cholecystitis, cholangitis, pyelonephritis, cystitis, pneumonia, pleural empyema, peritonitis, sepsis, ventriculitis, purulent skin and soft tissue infections, wound infection, burn infection, infections of bones and joints;
• for external use: pyoderma (including gangrenous), superficial folliculitis, furunculosis, sycosis, paronychia, infected seborrheic dermatitis, infected acne, secondary bacterial infection in fungal and viral infections of the skin, infected skin wounds of various etiologies (burns, wounds, difficult healing ulcers, insect bites), infected varicose ulcers;
• for topical application: blepharitis, blepharoconjunctivitis, dacryocystitis, conjunctivitis, keratitis, keratoconjunctivitis, meibomite.

Forms of release

Gentamicin ointment 0.1%

Eye drops 0.3% (Dexa).

Solution for intravenous and intramuscular injection (injections in ampoules for injection).

Other forms, whether it's a pill or cream does not exist.

Instructions for use and dosage

Established individually, taking into account the severity of the course and localization of infection, the sensitivity of the pathogen.

When administered intravenously or intramuscularly for adults, a single dose is 1-1.7 mg / kg, a daily dose of 3-5 mg / kg; the frequency of administration is 2-4 times a day. The course of treatment is 7-10 days. Depending on the etiology of the disease, it is possible to use in a dose of 120-160 mg once a day for 7-10 days or 240-280 mg once. In / in the infusion is carried out for 1-2 hours.

For children over 2 years of age, the daily dose of gentamicin is 3-5 mg / kg; multiplicity of administration - 3 times a day. Premature and newborn children are prescribed in a daily dose of 2-5 mg / kg; multiplicity of administration - 2 times a day; Children under 2 years of age are prescribed the same dose at a frequency of 3 times a day.

Patients with impaired renal excretory function require a correction of the dosing regimen depending on the values ​​of the CK.

When topical application of gentamicin is instilled in 1-2 drops in the lower conjunctival sac of the affected eye every 1-4 hours.

For external use, apply 3-4 times a day.

Maximum daily doses: for adults and children with / in or in / m introduction - 5 mg / kg.

Side effect

• nausea, vomiting;
• anemia, leukopenia, granulocytopenia, thrombocytopenia;
• oliguria;
• proteinuria;
• microhematuria;
• kidney failure;
• headache;
• drowsiness;
• hearing loss;
• irreversible deafness;
• skin rash;
• itching;
• hives;
• fever;
• angioedema.

Contraindications

• increased sensitivity to gentamicin and other antibiotics of the aminoglycoside group;
• neuritis of the auditory nerve;
• severe renal dysfunction;
• uremia;
• pregnancy;
• lactation (breastfeeding).

Application in pregnancy and lactation

Gentamicin is contraindicated in pregnancy. If necessary, use during lactation should stop breastfeeding.

Use in children

The application is possible according to the dosing regimen.

special instructions

With caution apply gentamicin for Parkinsonism, myasthenia gravis, renal dysfunction.When gentamycin is used, the functions of the kidneys, auditory and vestibular apparatus should be monitored.

With external application of gentamicin for a long time on large surfaces of the skin, it is necessary to take into account the possibility of resorptive action, especially in patients with chronic renal insufficiency.

Drug Interactions

When used simultaneously with aminoglycosides, vancomycin, cephalosporins, ethacrynic acid, oto- and nephrotoxic action may be enhanced.

With concomitant use with indomethacin, there is a decrease in clearance of gentamicin, an increase in its concentration in the blood plasma, and the risk of developing toxic effects increases.

With simultaneous use with funds for inhalation anesthesia, opioid analgesics increase the risk of developing neuromuscular blockade, up to the development of apnea.

With the simultaneous use of gentamycin and loop diuretics (furosemide, ethacrynic acid), the concentration of gentamicin in the blood increases, which increases the risk of toxic side effects.

Analogues of the drug Gentamycin

Structural analogs for the active substance:

• Garamycin;
• Gentamycin Acos;
• Gentamicin K;
• Gentamicin Ferein;
• Gentamycin sulfate;
• Gentamicin sulphate solution for injection 4%;
• Gentamicin ointment.

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