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Aminoglycoside Antibiotic

Gentamicin (Orthopaedic — Bone Cement and Systemic)

Brand names: Cidomycin, Garamycin, Simplex with Tobramycin (cement)

Gentamicin is an aminoglycoside antibiotic used in orthopaedics both systemically against Gram-negative and selected staphylococcal infections and locally as gentamicin-impregnated bone cement or beads for surgical-site and prosthetic-joint infection prophylaxis or treatment.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It binds the bacterial 30S ribosomal subunit to inhibit protein synthesis and is bactericidal; local cement/bead delivery achieves high regional concentrations with low systemic exposure.

Prescribing in practice

  • Systemic gentamicin is nephrotoxic and ototoxic, so it requires careful dosing by weight and renal function with therapeutic drug monitoring; cochlear and vestibular damage may be irreversible.
  • Avoid or use with particular caution in renal impairment, the elderly, and alongside other nephrotoxic or ototoxic agents.
  • Local gentamicin-loaded cement is generally well tolerated systemically, but document any aminoglycoside allergy before implantation.

Monitoring

For systemic use monitor serum gentamicin levels, renal function and for auditory or vestibular symptoms throughout treatment.

Counselling the patient

  • Report any hearing changes, ringing in the ears, dizziness or unsteadiness promptly.
  • Blood tests are needed to keep the systemic dose safe.
  • Antibiotic-containing cement is part of your joint surgery to help prevent infection.

Evidence & guidelines

MHRA guidance highlights the dose-related nephrotoxic and ototoxic risks of aminoglycosides, supporting therapeutic drug monitoring for systemic use.

Reference: Hartford Nomogram (Aminoglycoside Dosing); NICE NG15; MHRA Ototoxicity Warning; NICE NG124; SPC Cidomycin; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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