| Mechanism | Bactericidal |
| Typical Dose | IV or drops only - 3-7mg/kg in 3 divided doses |
| Indications | Serious aerobic gram -ve infections Otitis Externa (drops) |
| Contra-indications | Myasthenia gravis Pregnancy (can cross placenta and damage foetal CNVIII) |
| Side-effects | Nephrotic and ototoxic (CNVIII) |
| Interactions | Cyclosporin: potentiates nephrotoxic effects Loop diuretics: potentiate nephrotoxic/ototoxic effects |
| Elimination | |
| Additional Notes | Narrow therapeutic index makes drug monitoring essential: * Peak 5-10mg/L, trough <2mg/L. * **In endocarditis:**peak 3-5mg/L, trough <1mg/L Not usually given for >10 days due to toxicity risk. Usually combined with penicillin +/- Metronidazole in serious infection. Can cause grey baby syndrome in neonates |