In this episode, I’ll discuss whether to use actual, ideal, or adjusted body weight when dosing gentamicin in pregnant patients.
Aminoglycosides such as gentamicin are very rarely used in pregnancy to treat infections. Gentamicin crosses the placenta, and is pregnancy category D. Case reports of congenital deafness following maternal use of streptomycin are responsible for the pregnancy category of D that gentamicin receives.
One indication that gentamicin is used for in pregnant patients is intrapartum chorioamnionitis. In one study of 126 women with this condition, gentamicin was dosed by actual body weight. A review article published in 2008 also found that the most common dose used in studies of gentamicin in pregnant patients was 5 mg/kg of actual body weight.
Therefore if gentamicin use in pregnancy cannot be avoided, actual body weight appears to be the dosing weight that has the most published evidence behind it.
Shout out to “Pharmacy Mari-Len” for the idea for this episode!
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