Sulfato de Gentamicina
Gentamicin Sulfate
Gentamicin sulfate
También conocido como: Gentocin · Garamycin · Amtech Gentamax 100 · Gentafuse · Gentaved · Gentozen · Legacy · Garasol · Garacin · Gen-Gard · Clinagel Vet · Easotic · Otomax · Tiacil · Genticin · gentamicin sulphate · gentamicini sulfas · NSC-82261 · Sch-9724 · Gentamicine · Gentamycin
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia de dosis v13 auditada
Evidencia estructurada para el cálculoSusceptible infections (extra-label)
Requiere verificación veterinaria
- q24h
NA
Contexto clínico obligatorio (3)
- NOTE: Most infectious disease clinicians agree that aminoglycosides should be dosed once a day in most patients (mammals) with uncompromised renal function. This dosing regimen yields higher peak levels with resultant greater bacterial kill, and as aminoglycosides exhibit a postantibiotic effect, surviving susceptible bacteria generally do not replicate as rapidly even when antibiotic concentrations are below MIC. Periods where levels are low may decrease the adaptive resistance (bacteria take up less drug in the presence of continuous exposure) that can occur. Once-daily dosing may also decrease the toxicity of aminoglycosides, as lower urinary concentrations may mean less uptake into renal tubular cells.
- ■ Therapeutic drug monitoring (TDM) when possible in patients with uncompromised renal function; highly recommended for patients with risk factors for nephrotoxicity. Peak and trough levels are determined through samples collected 30 minutes after administration (peak) and immediately before administration of the next dose (trough). Generally, peak levels (≈30 to 60 minutes post IV dose) should be greater than 32 μg/mL and trough levels less than 1 – 2 μg/mL. 34 A clinical laboratory may be able to assist in sample-time determination and dosage amount and frequency adjustment.
- Gentamicin sulfate for injection and the oral solution should be stored at room temperature (15°C-30°C [59°F-86°F]); freezing or temperatures above 40°C (104°F) should be avoided. The soluble powder should be stored from 2°C to 30°C (46°F-86°F). Do not store or offer medicated drinking water in rusty containers or the drug may be destroyed.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La gentamicina es un potente antibiótico aminoglucósido parenteral utilizado principalmente para infecciones bacterianas aeróbicas gramnegativas graves.
Las características farmacológicas clave incluyen:
- Espectro de actividad: Excelente contra aerobios gramnegativos (p. ej., E. coli, Klebsiella, Proteus, Pseudomonas, Salmonella) y algunos estafilococos. Es inactivo contra anaerobios, hongos y virus.
- Actividad bactericida dependiente de la concentración: La eficacia se basa en alcanzar una concentración sérica máxima alta en relación con la Concentración Inhibitoria Mínima (CIM) del patógeno.
- Efecto post-antibiótico (EPA): El crecimiento bacteriano permanece suprimido incluso después de que las concentraciones del fármaco caen por debajo de la CIM, lo que respalda la práctica moderna de la dosificación una vez al día.
- Perfil de toxicidad: Debido a los riesgos significativos de nefrotoxicidad y ototoxicidad, el uso sistémico generalmente se reserva para infecciones graves donde las alternativas menos tóxicas son ineficaces.
Perla clínica: Los factores de riesgo de toxicidad incluyen enfermedad renal preexistente, edad (neonatos y geriátricos), fiebre, sepsis y deshidratación. Los gatos son particularmente sensibles a los efectos vestibulares (ototóxicos).
Mecanismo de acción
Gentamicin is a concentration-dependent bactericidal antibiotic.
- Mechanism: It actively transports across the bacterial cell membrane via an oxygen-dependent mechanism → irreversibly binds to the 30S ribosomal subunit → causes misreading of mRNA → inhibits bacterial protein synthesis, leading to cell death.
- Environmental Factors: Antimicrobial activity is significantly enhanced in an alkaline environment and inhibited in acidic, purulent, or necrotic environments.
- Resistance: Because the transport mechanism requires oxygen, anaerobic bacteria are inherently resistant to all aminoglycosides.
Seguridad y advertencias
Contraindicaciones
- Known hypersensitivity to aminoglycosides
- Use with extreme caution in preexisting renal disease
- Use with caution in working dogs (e.g., seeing-eye, herding, hearing-impaired assistance dogs) due to irreversible ototoxicity
- Use with caution in patients with neuromuscular disorders (e.g., myasthenia gravis)
- Do not use in animals with botulism
- Use with caution in rabbits (adversely affects GI flora)
- Use with caution in neonates, geriatrics, and dehydrated patients
- Perforated tympanum (for aural preparations)
- Concurrent use of other nephrotoxic drugs
- Systemic use exceeding 7 days
- Pregnancy
Efectos adversos
- Nephrotoxicity (tubular necrosis)
- Ototoxicity (auditory and vestibular; cats are highly sensitive to vestibular effects)
- Facial edema
- Pain or inflammation at the injection site
- Peripheral neuropathy
- Hypersensitivity reactions
- Rarely: GI signs, hematologic, and hepatic effects
- Nephrotoxicity (acute tubular necrosis)
- Neuromuscular blockade (rare)
- Delayed epithelial healing of corneal ulcers (ophthalmic use)
- Local irritation
Precauciones
Aminoglycosides are eliminated primarily through renal mechanisms; use cautiously with serum monitoring and dosage adjustments in neonatal or geriatric animals. Sighthound dogs have significantly smaller volumes of distribution and may require reduced dosages. IM injections in horses can cause muscle irritation; IV is preferred. Monitor for antibiotic-associated diarrhea/colitis in horses (may promote Beta-2 toxin production by C. perfringens).
Interacciones farmacológicas
Synergistic effects against some bacteria; however, potential for in vitro inactivation of aminoglycosides (do not mix in the same syringe/bag) and in vivo inactivation in patients with renal failure.
Potential additive nephrotoxicity (well documented with older cephalosporins like cephalothin).
Concurrent use may increase the nephrotoxic or ototoxic potential of aminoglycosides.
Increased risk for nephrotoxicity.
Concomitant use could potentiate neuromuscular blockade.
Increased risk of nephrotoxicity and ototoxicity
Increased risk of nephrotoxicity and ototoxicity
In vitro chemical inactivation (do not mix in same syringe)
Enhanced neuromuscular blockade
Monitorización
- Clinical efficacy (resolution of clinical signs, negative cultures)
- Renal toxicity: Baseline and ongoing urinalysis (casts in urine are often the initial sign of impending nephrotoxicity), serum BUN, and creatinine
- Gross monitoring for vestibular (balance) or auditory (hearing) toxicity
- Therapeutic Drug Monitoring (TDM): Serum levels drawn at 1, 2, and 4 hours post-dose. Peak should be >20 mcg/mL; 4-hour trough should be <10 mcg/mL
- Urinalysis (monitor for cellular casts as an early indicator of tubular damage)
- Serum creatinine and BUN
- Hydration status
- Therapeutic Drug Monitoring (TDM): Peak >20 μg/ml, Trough <1 μg/ml
- Auditory and vestibular function
Farmacocinética
Vida media
Absorción
Not appreciably absorbed after oral or intrauterine administration. Absorbed from topical administration during surgical irrigations. Bioavailability from extravascular injection (IM or SC) is >90%. Peak levels occur 0.5 to 1 hour after IM administration.
Distribución
Distributed primarily in extracellular fluid. Accumulates in inner ear and kidneys. Minimal protein binding (<20%). Does not readily cross the blood-brain barrier or penetrate ocular tissue. Vd is 0.15-0.3 L/kg in adult dogs/cats, and 0.26-0.58 L/kg in horses. Crosses the placenta.
Metabolismo
Not significantly metabolized.
Eliminación
Eliminated almost entirely by glomerular filtration. Patients with decreased renal function can have significantly prolonged half-lives.
Sobredosis
In the event of an inadvertent overdose, three treatments are recommended:
- Hemodialysis: Very effective in reducing serum levels, but rarely a viable option in veterinary medicine.
- Peritoneal dialysis: Reduces serum levels but is much less effective than hemodialysis.
- Complexation: Administration of ticarcillin (12-20 g/day in humans) is reportedly nearly as effective as hemodialysis in complexing and deactivating the drug.
Productos disponibles
Formulaciones
- Injection (100 mg/mL, 40 mg/mL, 10 mg/mL, 5 mg/mL, etc.)
- Oral solution (5 mg/mL)
- Soluble powder
- Ophthalmic preparations
- Otic preparations
- Topical preparations
- Injectable solution: 40 mg/ml, 100 mg/ml
- Ophthalmic gel: 0.3% w/w
- Ophthalmic drops: 0.5% w/v
- Aural drops/ointment: Combination products (e.g., with miconazole/hydrocortisone or clotrimazole/betamethasone)
Veterinario
- Gentamicin Sulfate Injection: 100 mg/mL (horses, poultry)
- Gentamicin Sulfate Injection: 5 mg/mL (piglets)
- Gentamicin Sulfate Oral Solution: 5 mg/mL (swine)
- Gentamicin Soluble Powder: 333.33 mg/g and 2 g/30 g (swine)
- Ophthalmic, otic, and topical preparations
- Clinagel Vet (Ophthalmic)
- Easotic (Aural combination)
- Genta (100 mg/ml Injectable)
- Otomax (Aural combination)
- Tiacil (Ophthalmic)
Etiquetado para humanos
- Gentamicin Sulfate Injection: 40 mg/mL, 10 mg/mL, 0.8 mg/mL, 0.9 mg/mL, 1 mg/mL, 1.2 mg/mL, 1.4 mg/mL, 1.6 mg/mL
- Topical, otic, and ophthalmic preparations
- Genticin (40 mg/ml Injectable)
Estado regulador
POM-V / POM status
POM-V / POM status
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store injection and oral solutions at room temperature (15-30°C); avoid freezing or temperatures above 40°C. Store soluble powder from 2-30°C. Do not store or offer medicated drinking water in rusty containers, as the drug may be destroyed.
Información para el cliente
La gentamicina es un antibiótico potente reservado para infecciones graves.
- Administración: Si se le ha indicado administrar inyecciones subcutáneas (debajo de la piel) en casa, asegúrese de haber recibido la capacitación adecuada por parte de su equipo veterinario.
- Riesgos de toxicidad: Este medicamento conlleva un riesgo significativo de daño renal (nefrotoxicidad) y problemas de audición/equilibrio (ototoxicidad).
- Qué observar: Comuníquese con su veterinario de inmediato si nota que su mascota bebe más agua de lo habitual, orina con mayor o menor frecuencia, vomita, pierde el apetito, muestra signos de sordera o presenta inclinación de cabeza, tropiezos o pérdida del equilibrio.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.