Download GENTAMICIN OPHTHALMIC Garamycin and Sandoz

GENTAMICIN OPHTHALMIC
Garamycin and Sandoz gentamicin ophthalmic products have been discontinued.1,2 Although several
other generic brands have been approved by Health Canada, none are currently being marketed in
Canada.3
Handling the shortage:
1. Is antibiotic therapy necessary?
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Conjunctivitis (pink-eye) may be bacterial, viral or allergic; antibiotics are only appropriate for
bacterial conjuncitivitis.4
o Bacterial – white, yellow or green purulent discharge; sticky eyelids; crusts on lashes
o Viral – thin, clear discharge; itchy eyes; often associated with head cold symptoms
o Allergic – itchy eyes; thin, clear or white ropey discharge
Bacterial conjunctivitis is a self-limiting condition and will resolve without treatment in 2 to 5
days in many cases.4
Topical antibiotic treatment decreases transmission, reduces risk of infection spreading to the
cornea and may reduce the number of days to symptom resolution.5
Some schools and daycare facilities will not allow children with pink-eye to attend until they
have received 24 hours treatment with a topical antibiotic.4
2. Alternatives to gentamicin:

Mild to moderate symptoms4,6:
o Erythromycin 0.5 % oint.
o Gramicidin-polymixin drops/oint (Polysporin, generics - OTC)
o Tobramycin 0.3 % drops/oint.
o Trimethoprim-polymixin drops (Polytrim, generics)
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Severe symptoms (contact lenses, corneal involvement, treatment failure)
o Besifloxacin 0.6 %
o Ciprofloxacin 0.3 % drops/oint
o Gatifloxacin 0.3 % drops
o Levofloxacin 0.5 % drops
o Moxifloxacin 0.5 % drops
o Ofloxacin 0.3 % drops
Note: while it is acceptable (but off-label) to use ophthalmic antibiotics for otic administration,7 only use
products that are indicated for ophthalmic use in the eyes.
Prepared by Karen Jensen BSP, MSc. Reviewed by Carmen Bell, BSP
medSask, Your Medication Information Service
June 17, 2013
REFERENCES:
1. Merck Medical Information line. Personal communication June 17. 2013
2. Sandoz Medical Information line. Person communication June 17, 2003
3. Health Canada. Drug Product Directorate - gentamicin ophthalmic
4. Anti-infective Review Panel. Anti-infective guidelines for community-acquired infections. Toronto:
MUMS Guideline Clearinghours: 2013.
5. Friesen A. Eye Care: Conjunctivitis in e-therapeutics+ Complete – Minor Ailments. Available at
www.e-therapeutics.ca by subscription. Accessed June 17, 2013.
6. Blondel-Hill E, Fryters S. Bugs & Drugs, 2012.
7. Alternative or 'off-label' routes of drug administration. Pharmacist's Letter/Prescriber's Letter
2006;22(10):221012.