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Gentamicin

CPT4 code

Name of the Procedure:

Gentamicin Administration
Common Name: Gentamicin
Technical Term: Aminoglycoside Antibiotic Therapy

Summary

Gentamicin administration is a process through which the antibiotic medication, Gentamicin, is given to treat serious bacterial infections. It is often administered intravenously or intramuscularly to combat severe infections that are not treatable with other antibiotics.

Purpose

Medical Condition/Problem Addressed:
  • Treatment of severe bacterial infections, including those resistant to other antibiotics.
  • Infections such as sepsis, respiratory infections, urinary tract infections, and intra-abdominal infections.
Goals/Expected Outcomes:
  • Eradication of the bacterial infection
  • Reduction in symptoms such as fever, pain, and inflammation
  • Prevention of infection spread

Indications

Specific Symptoms/Conditions:
  • Fever, chills, and signs of systemic infection
  • Positive bacterial culture tests indicating gentamicin-sensitive organisms
  • Complex or recurrent urinary tract infections
Patient Criteria:
  • Patients who have severe infections not responding to other antibiotics
  • Those with medical history showing susceptibility to gentamicin
  • Individuals with normal kidney function or minor renal impairments

Preparation

Pre-Procedure Instructions:
  • Review of current medications to avoid interactions
  • Laboratory tests, including kidney function tests (e.g., serum creatinine) and hearing tests, to monitor gentamicin levels and potential side effects
Diagnostic Tests/Assessments:
  • Blood tests to check for infection markers and kidney function
  • Bacterial culture and sensitivity tests to confirm gentamicin efficacy

Procedure Description

Step-by-Step Explanation:
  1. Dosage Calculation: Based on the patient’s weight, kidney function, and severity of infection.
  2. Administration: Given either intravenously through an IV line or intramuscularly into a large muscle. IV administration involves diluting gentamicin in saline and infusing it over 30 minutes.
  3. Monitoring: Regular checks of blood levels, kidney functions, and auditory tests to prevent toxicity.
Tools/Equipment:
  • Syringes, IV lines, infusion pumps
  • Saline solution for dilution (if IV route)
Anesthesia/Sedation:
  • Not required for gentamicin administration

Duration

  • Each dose infusion typically takes approximately 30 minutes.
  • The course of treatment spans from 7 to 14 days, depending on infection severity.

Setting

  • Hospital, outpatient clinic, or home healthcare setting under professional supervision.

Personnel

  • Healthcare professionals involved include doctors (usually an infectious disease specialist), nurses, and pharmacists.

Risks and Complications

Common Risks:
  • Kidney damage (nephrotoxicity)
  • Hearing loss (ototoxicity)
  • Imbalances in electrolytes such as potassium and magnesium
Rare Risks:
  • Neurological toxicity leading to muscle weakness
Possible Complications Management:
  • Regular monitoring and adjustment of dosage based on blood levels and kidney function assessments

Benefits

  • Quick resolution of bacterial infections
  • Prevention of infection-related complications
  • Improved overall health and return to normal activities

Recovery

Post-Procedure Care:
  • Continue monitoring kidney function and auditory tests
  • Maintain hydration and balanced nutrition
Expected Recovery Time:
  • Symptoms start to improve within a few days; complete recovery varies based on infection severity
Restrictions/Follow-Up:
  • Regular follow-up appointments for monitoring
  • Avoidance of other nephrotoxic drugs during treatment

Alternatives

Other Treatment Options:
  • Other antibiotics such as vancomycin, ciproflaxacin, or beta-lactams.
Pros and Cons:
  • Alternatives may have fewer side effects but might not be as effective against resistant infections.
  • Gentamicin is a potent option for severe cases.

Patient Experience

During Procedure:
  • Minimal discomfort if administered as per protocol
  • Possible slight pain at injection site if intramuscular
After Procedure:
  • Monitoring for side effects like reduced urine output or hearing issues
  • Pain management generally not required due to the nature of the medication

Pain management and comfort measures include ensuring adequate hydration and regular medical supervision.

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