Gentamicin side effects and benefits, toxicity and dosing, how to prevent adverse effects and toxicity with natural vitamins and spices
January 4 2017 by Ray Sahelian, M.D.

Gentamicin is an aminoglycoside antibiotic used in the treatment of many types of bacterial infections, particularly Gram-negative infection.

Natural ways to reduce gentamicin toxicity
Curcumin benefit in reducing gentamicin toxicity
J Physiol Pharmacol. 2014. Thymoquinone and curcumin prevent gentamicin-induced liver injury by attenuating oxidative stress, inflammation and apoptosis. It can be concluded that thymoquinone and curcumin successfully prevents the deleterious effects on liver function and histological integrity to more or less the same degree by enhancing anti-oxidant defense system, suppression of oxidative stress and attenuation of inflammation and apoptosis.

Acetylcysteine may help prevent or reduce hearing loss
J Laryngol Otol. 2016. Prevention of gentamicin ototoxicity with N-acetylcysteine and vitamin A. Gentamicin-induced hearing loss in rats may be prevented by the concomitant use of vitamin A and N-acetylcysteine. Specifically, N-acetylcysteine appeared to have a more protective effect than vitamin A for a greater range of noise frequencies.

Garlic
Clin Exp Otorhinolaryngol. 2016. The Effect of Garlic Derivatives (S-Allylmercaptocysteine, Diallyl Disulfide, and S-Allylcysteine) on Gentamicin Induced Ototoxicity: Gentamicin is a potent aminoglycoside antibiotic. Ototoxicity and nephrotoxicity are the main side effects which restrict the use of gentamicin. Garlic with its intrinsic antioxidant activity may prove beneficial in prevention from ototoxicity. S-allylmercaptocysteine (SAMC), diallyl disulfide (DD), and S-allylcysteine (SAC) are three active compounds found in garlic.

Asian Pac J Trop Biomed. 2013. Modulatory effects of dietary inclusion of garlic (Allium sativum) on gentamycin-induced hepatotoxicity and oxidative stress in rats. Functional Foods, Nutraceuticals and Phytomedicine Unit, Department of Biochemistry, Federal University of Technology, Akure, P.M.B. Akure, Nigeria. To investigate the ameliorative effect of dietary inclusion of garlic (Allium sativum) on gentamycin-induced hepatotoxicity in rats. Adult male rats were randomly divided into four groups with six animals in each group. Groups 1 and 2 were fed basal diet while Groups 3 and 4 were fed diets containing 2% and 4% garlic respectively for 27 d prior to gentamycin administration. Hepatotoxicity was induced by the intraperitoneal administration of gentamycin (100 mg/kg body weight) for 3 d. The liver and plasma were studied for hepatotoxicity and antioxidant indices. Gentamycin induces hepatic damage as revealed by significant elevation of liver damage marker enzymes (aspartate transaminase and alanine aminotransferase) and reduction in plasma albumin level. Gentamycin also caused a significant alteration in plasma and liver enzymatic (catalase, glutathione and super oxygen dehydrogenises) and non-enzymatic (glutathione and vitamin C) antioxidant indices with concomitant increase in the malondialdehyde content; however, there was a significant restoration of the antioxidant status coupled with significant decrease in the tissues' malondialdehyde content, following consumption of diets containing garlic. These results suggest that dietary inclusion of garlic powder could protect against gentamycin-induced hepatotoxicity, improve antioxidant status and modulate oxidative stress; a function attributed to their phenolic constituents.

Int Braz J Urol. 2014. Garlic supplemented diet attenuates gentamicin nephrotoxicity ın rats.

Green tea and CoQ10 may be helpful in gentamicin toxicity
Modification of biochemical parameters of gentamicin nephrotoxicity by coenzyme Q10 and green tea in rats.
Indian J Exp Biol. 2006. Upaganlawar A, Farswan M, Rathod S. Pharmacy Department, Faculty of Technology and Engineering, Maharaja Sayajirao University of Baroda, Vadodara, India.
The present study was designed to investigate the possible potential protective role of coenzymeQ10 (CoQ10; 10 mg/kg/day, ip) and/or green tea; 25mg/kg/day, po) against gentamicin (GM) nephrotoxicity. Marked increase in the level of serum urea. creatinine and lipid peroxidation (LPO) content was found after administration of gentamicin (80 mg/kg/day, ip) for eight days along with significant decrease in the antioxidant enzymes, superoxide dismutase (SOD), reduced glutathione (GSH), catalase (CAT) as well as brush border enzymes (Na+/K+ ATPase, Mg(+2)ATPase and Ca2+ ATPase). Treatment with CoQ10 or green tea alone with GM showed significant decrease in serum urea, creatinine and tissue LPO content and significant increase in antioxidant and membrane bound enzymes. Combined treatment with CoQ10 and green tea was more effective in mitigating adverse effect of GM nephrotoxicity. The present work indicated that CoQ10 and green tea due to their antioxidant activity modified the biochemical changes occurred during gentamicin nephrotoxicity and thus had a potential protective effect.

Olive leaf extract
Inhibitory effect of olive leaf extract on gentamicin-induced nephrotoxicity in rats. Iran J Kidney Dis. 2012.

Gentamicin side effects
Gentamicin can cause severe side effects including hearing loss and kidney problems. Additional gentamicin side effects include dizziness, ringing in the ears, hearing loss, numbness, muscle twitching or weakness, difficulty breathing, decreased urination, rash, itching, or sore throat.

Neurologist. 2012. Gentamicin-induced myoclonus: a case report and literature review of antibiotics-induced myoclonus.

Drug interactions
Gentamicin side effects can become worse when used in conjunction with diuretics, cisplatin (Platinol), amphotericin (Amphotec, Fungizone), and other antibiotics.