Nebulised Gentamicin

40mg/ml for Inhalation

INDICATION AS PER FUKKM

Not in the blue book/national formulary

Has been used off-label for the treatment of
Cystic Fibrosis and Bronchiectasis
 RATIONALE OF APPLICATION
• Gentamicin is an aminoglycoside antibiotic with broad-spectrum bactericidal
activity.
• Gentamicin is usually active against most strains of the following organisms:
Escherichia coli, Klebsiella spp., Proteus spp., Pseudomonas aeruginosa,
Staphylococci, Enterobacter spp., Citrobacter spp and Providencia spp.
• Studies have shown that the most common pathogens to chronically colonise
patients with bronchiectasis are Haemophilus influenzae and Pseudomonas
aeruginosa.2
• The British Thoracic Society (BTS) recommends that long term nebulised
antibiotics should be considered for patients with frequent exacerbations or
increased morbidity.1
• The BTS also recommends that antibiotics should be started based on
sensitivities and that if gentamicin is used it should be given at a dose of 80mg
nebulised BD.
• Alongside its bactericidal action gentamicin is thought to reduce
myeloperoxidase activity which helps to prevent inflammation and tissue
damage.

1. Pasteur MC et al. British Thoracic Society Guideline for non-CF Bronchiectasis. Thorax. 2010;65:i1-i58.
2. Emmons E. Bronchiectasis. WebMD LLC. 2015. Available from: emedicine.medscape.com/article/296961- overview.
RATIONALE OF APPLICATION
(CONT’)