A prospective laboratory-based audit of gentamicin use and therapeutic monitoring

The Journal of Antimicrobial Chemotherapy
N J SaundersW A Lynn

Abstract

We report a study investigating the proportion of patients in whom therapeutic serum concentrations of gentamicin are achieved in the early phase of treatment and to determine the underlying reasons for sub-optimal therapy. A laboratory based prospective study of 83 courses of gentamicin was performed (excluding patients receiving renal replacement therapy or with bacterial endocarditis) in a London teaching hospital. Of 83 monitored courses 74 had paired levels tested. Initial trough concentrations were > 2 mg/L in nine (12%) and were < 1 mg/L in 51 (69%) indicating levels were seldom in the toxic range. The first monitored peaks were sub-therapeutic in 58 (78%) courses using a cut-off of 5 mg/L and only seven (9%) were greater than 6 mg/L. Of these seven patients, six had troughs levels of greater than 2 mg/L. Of those with initial levels below 5 mg/L, 33 had further serum levels tested, of which 26 (79%) remained below 5 mg/L. Of those for whom dosing information was available 73% received 80 mg t.d.s. and the mean dose for those for which body weight was known was 3.3 mg/kg/day (S.D. = 0.7). Most patients continued to receive 8-hourly dosing with 80 mg of gentamicin, leading to subtherapeutic peak levels in the majority of ...Continue Reading

Citations

Sep 6, 2000·Journal of Clinical Pharmacy and Therapeutics·K K Adjepon-YamoahM E Ahmed

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aminoglycosides

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.

Aminoglycosides (ASM)

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.