Important:
Therapy
Co-trimoxazole 960mg IV or PO every 12 hours
plus
Gentamicin as per Gentamicin Dosage Guidelines for max. 72 hours only.
Stop gentamicin after 72 hours of treatment as per Gentamicin 72 hour review algorithm
Notes:
Co-trimoxazole contains trimethoprim and sulfamethoxazole. Do not use this agent in pregnancy. Trimethoprim is contraindicated in the first trimester of pregnancy due to a risk of neural tube defects; sulfamethoxazole can cause neonatal haemolysis and methaemoglobinaemia in the last trimester.
Gentamicin should be avoided in patients with decompensated liver disease (jaundice, ascites, encephalopathy, variceal bleeding or hepato-renal syndrome). Gentamicin must not be administered to patients with myasthenia gravis as it can precipitate a myasthenic crisis.
Refer also to the HAP algorithm