Guidelines for Gentamicin Dosing

Dosing:
Recommended dose for all patients is 4 mg/kg/dose
Dosing Intervals:
PMA Postnatal Age Interval
(Weeks) (Days) (Hours)
≤ 29* 0 to 7 48
8 to 28 36
≥ 29 24
30 to 34 0 to 7 36
≥8 24
≥ 35 All 24
*Infants with significant asphyxia, PDA, or treatment with indomethacin should be included in
this category

Administration:
Gentamicin is diluted to 2 mg/ml and infused over 30 minutes

Monitoring:
 Measure serum concentrations when treating for more than 48 hours.
 Obtain peak concentration 30 minutes after end of infusion, and trough concentration 30
minutes prior to the next dose.
 When treating patients with serious infections, significant renal dysfunction, or altered fluid
status, consider measuring serum concentration 24 hours after a dose, and use the chart below
for the suggested dosing interval.
Level at 24 hours Suggested Dosing Interval
(mcg/ml) (hours)
≤1 24
1.1 to 2.3 36
2.4 to 3.2 48
≥ 3.3 Measure level in 24 hours
 Consider following biweekly creatinine levels when treating for more than 48 hours.
 Hearing screens to be obtain on all infants prior to hospital discharge.
 Therapeutic serum concentrations:
‐ Peak: 5 to 10 mcg/ml
‐ Trough: < 1 mcg/ml

References:
Neofax 2009

Reviewed/Revised: 6/2010 by
Samir Alabsi, MD
Kelli DeVore, Pharm. D, BCPS
Rebecca Willson MSN, NNP-BC