Gentamicin

Gentamicin is a aminoglycoside antibiotic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Treatment of susceptible bacterial eye infections such as bacterial conjunctivitis, blepharitis, or keratitis when an antibiotic is appropriate.
• Treatment of susceptible bacterial ear infections such as otitis externa, only when the eardrum is intact or a specialist advises use.
• Topical treatment of susceptible bacterial skin infections, including infected minor wounds or infected dermatitis, when suitable.
• Injectable treatment of serious infections caused by susceptible bacteria, often Gram-negative bacteria, such as sepsis, complicated urinary tract infection, lower respiratory tract infection, intra-abdominal infection, bone or joint infection, or skin and soft-tissue infection, usually in hospital and sometimes with other antibiotics.

Dosage of Gentamicin depends on the dosage form, infection site, severity, kidney function, body weight, age, and culture results. Eye drops, ear drops, ointment, or cream should be used exactly as directed and for the full prescribed duration. Injectable Gentamicin requires careful medical supervision, kidney-function monitoring, and sometimes blood-level monitoring; the prescriber will determine the dose and dosing interval. Do not self-start or repeat treatment without medical advice.

• Eye preparations: temporary burning, stinging, irritation, redness, blurred vision, or eyelid itching.
• Ear preparations: local irritation, itching, discomfort, or rarely hearing or balance problems, especially if used with a damaged eardrum.
• Skin preparations: burning, itching, redness, rash, dryness, or contact dermatitis.
• Injection: nausea, injection-site pain, kidney function changes, dizziness, ringing in the ears, hearing loss, balance problems, muscle weakness, or allergic reactions.
• Serious reactions needing urgent medical help include severe rash or swelling, breathing difficulty, reduced urine, marked dizziness, hearing changes, severe diarrhoea, or signs of worsening infection.

Use Gentamicin carefully in people with kidney disease, dehydration, older age, hearing or balance problems, myasthenia gravis or other neuromuscular disorders, and in newborns or premature infants. Avoid prolonged or repeated courses unless clearly prescribed, as this may increase toxicity or encourage resistant organisms. Ear preparations should not be used if the eardrum is perforated, there are ear tubes, or ear surgery has occurred unless an ENT specialist advises it. Eye preparations are for the eye only; do not touch the dropper tip and avoid contact lenses during active eye infection unless advised. Use under the guidance of a registered doctor or pharmacist.

• Other aminoglycosides or medicines that can harm the kidneys or hearing may increase toxicity risk, including amikacin, tobramycin, vancomycin, amphotericin B, cisplatin, ciclosporin, tacrolimus, and some cephalosporins.
• Loop diuretics such as furosemide or ethacrynic acid can increase the risk of hearing damage, especially with injectable Gentamicin.
• Neuromuscular blockers, general anaesthetics, or medicines that affect muscle transmission may increase the risk of breathing or muscle weakness.
• Indomethacin may increase aminoglycoside levels in newborns; specialist monitoring is needed.
• No important food interaction is expected, but hydration and kidney monitoring may be important during injectable therapy.

• Known allergy or serious hypersensitivity to Gentamicin or other aminoglycoside antibiotics.
• Use of ear preparations when the eardrum is perforated or ear tubes are present, unless specifically prescribed by an appropriate specialist.
• Use of topical skin preparations in the eye or injection of non-injectable preparations.

During pregnancy, Gentamicin should be used only when clearly needed and prescribed, because aminoglycosides can cross the placenta and may carry a potential risk of fetal hearing or kidney harm, especially with injectable use. Eye, ear, or skin use may have lower absorption but still needs professional advice. During breastfeeding, small amounts may pass into milk; injectable use is generally considered low oral exposure for the infant, but monitoring for diarrhoea, rash, or thrush is prudent. Consult a doctor before use in pregnancy or breastfeeding.

Store at room temperature as stated on the product label, away from heat, moisture, and direct light. Do not freeze unless the label says so. Keep containers tightly closed and out of reach of children. Do not use if the solution changes colour, becomes cloudy, or the expiry date has passed. Eye and ear drops should usually be discarded after the recommended period after opening, commonly 4 weeks, unless the label or pharmacist gives different advice.