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Suggest Dosage For Gentamicin

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Posted on Wed, 6 Jan 2016
Question: With past MRSA sinus infections I used a sinus irrigation of 160mg gentamicin in a L of NSS. Successfully several times over 20 years. I've recently moved an my new ENT Dr has prescribed irritations but the dose is a 8o mg capsule in 10 ml of NSS, BID My Internet search shows 160mg in a L as a frequently used concentration.
I am concerned about this very large increase in concentration. Please give me your comments about this dose.
Thanks
doctor
Answered by Dr. Sumit Bhatti (2 hours later)
Brief Answer:
There should be no major problem.

Detailed Answer:
Hi,

Thank you for your query.

1. A concentrated solution of gentamicin should cause no harm.

2. However, every concentration of this solution will involve absorption into the body with possible side effects as with intravenous administration.

3. You may have 'Biofilm' formation. This would explain the recurrent infections. Very dilute solution could lead to development of resistance.

4. Get a deep nasal swab for MRSA. VISA (Vancomycin Intermediate-resistant Staphylococcus Aureus) and VRSA (Vancomycin Resistant Staphylococcus Aureus) also exist.

5. Get a plain Sinus CT Scan done and upload the images. Upload the swab reports. Also send the swabs for fungal culture and a bacterial PCR (Polymerase Chain Reaction) test that is more sensitive.

6. You should try hypertonic saline nasal solutions in addition.

I hope I have answered your query. If you have any follow up queries, I will be available to answer them.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Suggest Dosage For Gentamicin

Brief Answer: There should be no major problem. Detailed Answer: Hi, Thank you for your query. 1. A concentrated solution of gentamicin should cause no harm. 2. However, every concentration of this solution will involve absorption into the body with possible side effects as with intravenous administration. 3. You may have 'Biofilm' formation. This would explain the recurrent infections. Very dilute solution could lead to development of resistance. 4. Get a deep nasal swab for MRSA. VISA (Vancomycin Intermediate-resistant Staphylococcus Aureus) and VRSA (Vancomycin Resistant Staphylococcus Aureus) also exist. 5. Get a plain Sinus CT Scan done and upload the images. Upload the swab reports. Also send the swabs for fungal culture and a bacterial PCR (Polymerase Chain Reaction) test that is more sensitive. 6. You should try hypertonic saline nasal solutions in addition. I hope I have answered your query. If you have any follow up queries, I will be available to answer them. Regards.