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In the event of overdose or toxic reactions, hemodialysis may aid in the removal of gentamicin from the blood, especially if renal function is, or becomes, compromised. The possibility of these phenomena occurring should be considered if gentamicin is administered to animals receiving general anesthesia and/or neuromuscular blocking agents such as succinylcholine or tubocurarine. In clinical field trials, gentamicin-betamethasone-clotrimazole was effective in the treatment of otitis externa associated with bacteria and Malassezia pachydermatis. There is evidence that cross resistance between gentamicin and the aminoglycoside antibiotics may occur since bacteria made resistant to aminoglycoside antibiotics artificially in the laboratory are also resistant to gentamicin; however, GENTOCIN Injectable Solution may be active against clinical isolates of bacteria resistant to other aminoglycosides. When monitoring gentamicin peak concentrations, dosage should be adjusted so that prolonged levels above 12 mcg/mL are avoided. Gentamicin is a bactericidal antibiotic which inhibits normal protein synthesis in susceptible bacteria. The rate of removal of gentamicin is considerably lower by peritoneal dialysis than it is by hemodialysis. Specifically, gentamicin is active against the following organisms commonly isolated from canine ears: Staphylococcus aureus, other Staphylococcus spp. Gentamicin was over eight times more active in vitro at pH 7. Among the gram-positive bacteria, in vitro sensitivity has been shown for Staphylococcus species (including penicillin and methicillin resistant strains) and betahemolytic streptococci which are sensitive to gentamicin. When monitoring gentamicin trough concentrations, dosage should be adjusted so that levels above 2 mcg/mL are avoided. Such bacterial infections, caused by organisms sensitive to gentamicin, include conjunctivitis, keratitis, keratoconjunctivitis, and superficial corneal ulcers of bacterial origin. After using gentamicin eye ointment, wipe the tip of the ointment tube with a clean tissue and keep the tube tightly closed. Usual Pediatric Dose for Tularemia:Use of tularemia as a biological weapon:Contained casualty setting: 15 mg/kg IV twice daily (maximum dose 1 g/day) for 10 days; may switch to oral ciprofloxacin when clinically indicatedThe Working Group on Civilian Biodefense has recommended ciprofloxacin as an alternative to streptomycin and gentamicin if they are contraindicated, not available, or inactive in vitro. After verifying that the eardrum is intact, instill 4 drops (2 drops from the 215 g bottle) of gentamicin-betamethasone-clotrimazole ointment twice daily into the ear canal of dogs weighing less than 30 lbs. Neuromuscular blocking action by gentamicin in animals may be antagonized by neostigmine or calcium. 2 g/dayOral: 20 mg/kg every 12 hoursMaximum dose: 2 g/dayUsual Pediatric Dose for Plague:Use of plague as a biological weapon:Treatment, contained-casualty setting: 15 mg/kg IV twice daily for 10 days (maximum 1 g/day); may switch to oral ciprofloxacin when clinically indicatedThe Working Group on Civilian Biodefense has recommended ciprofloxacin as an alternative to streptomycin and gentamicin if they are contraindicated, unavailable, or inactive in vitro. After initial administration to humans with normal renal function, 30-100% of the gentamicin is recoverable in the urine in 24 hours. Usual Adult Dose for Tularemia:Use of tularemia as a biological weapon:Treatment, contained casualty setting: 400 mg IV twice daily for 10 days; may switch to oral ciprofloxacin 500 mg twice daily when clinically indicatedTreatment, mass casualty setting and postexposure prophylaxis: 500 mg orally twice daily for 14 daysThe Working Group on Civilian Biodefense has recommended ciprofloxacin as an alternative to streptomycin and gentamicin if they are contraindicated, not available, or inactive in vitro. 5 Any amount of gentamicin absorbed in the circulatory system is excreted unchanged in the urine by glomerular filtration. Gentamicin sulfate USP, betamethasone valerate, USP and clotrimazole, USP ointment reduced discomfort, redness, swelling, exudate, and odor, and exerted a strong antimicrobial effect. Gentamicin ophthalmic preparations are used to treat infections of the eye. Usual Adult Dose for Plague:Treatment of plague used as a biological weapon:Treatment, contained-casualty setting: 400 mg IV every 12 hours for 10 days; may switch to oral ciprofloxacin 500 mg twice daily when clinically indicatedThe Working Group on Civilian Biodefense has recommended ciprofloxacin as an alternative to streptomycin and gentamicin if they are contraindicated, unavailable, or inactive in vitro. , Clinical Evaluation of Gentamicin in Bacterial Infections of the Canine and Feline Eye, Vet. Gentamicin crosses the peritoneal as well as the placental membrane. , Gentamicin: Antibacterial Activity, Clinical Pharmacology and Clinical Applications, Medical Times, Vol. If hearing or vestibular dysfunction is noted during the course of treatment, discontinue use of gentamicin-betamethasone-clotrimazole ointment immediately and flush the ear canal thoroughly with a non-ototoxic solution. , et al, Clinical and Bacteriologic Evaluation of Gentamicin Ophthalmic Preparations, Amer. In vitro tests have determined that gentamicin is bactericidal and acts by inhibiting normal protein synthesis in susceptible microorganisms.
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