A randomized, prospective study comparing once-daily gentamicin versus thrice-daily gentamicin in the treatment of puerperal infection

Mitra, Avick G.; Whitten, Matthew; Laurent, Sherry L.; Anderson, William E.

doi:10.1016/s0002-9378(97)70269-2

Cited by 47 publications

(35 citation statements)

References 20 publications

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“…14 Substantial cost savings were similarly noted in the studies by Del Priore et al and Mitra et al 15,16 …”

Section: Costmentioning

confidence: 79%

“…The less-frequent dosing schedule was associated with similar outcomes to those with conventional dosing. 16 Given the difficulty in establishing therapeutic levels with multiple daily doses in obstetric patients, once-daily dosing of gentamicin is appealing in this population. There are no data on once-daily gentamicin for gynecologic infections, although this regimen is becoming widely used in many centers.…”

Section: Once-daily Gentamicin Wiesenfeld and Heinementioning

confidence: 99%

See 1 more Smart Citation

The use of once-daily dosing of gentamicin in obstetrics and gynecology

Wiesenfeld

Heine

1998

Infect. Dis. Obstet. Gynecol.

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Gentamicin is a widely‐used antimicrobial agent for obstetric and gynecologic infections. Renewed excitement in this antibiotic has arisen from recent information supporting less frequent dosing. In this symposium, we will describe the pharmacokinetics of gentamicin and review new information advocating the use of once‐daily administration of gentamicin. Infect. Dis. Obstet. Gynecol. 6:155–159, 1998. © 1998 Wiley‐Liss, Inc.

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“…14 Substantial cost savings were similarly noted in the studies by Del Priore et al and Mitra et al 15,16 …”

Section: Costmentioning

confidence: 79%

Section: Once-daily Gentamicin Wiesenfeld and Heinementioning

confidence: 99%

The use of once-daily dosing of gentamicin in obstetrics and gynecology

Wiesenfeld

Heine

1998

Infect. Dis. Obstet. Gynecol.

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“…The results of this study support the conclusions of two reports of once-daily gentamicin in the treatment of puerperal uterine infections. 9,10 Oncedaily dosing of gentamicin for the treatment of postpartum endometritis is efficacious and costeffective, and it appears that this regimen is not associated with a high incidence of nephrotoxicity or ototoxicity.…”

Section: Discussionmentioning

confidence: 99%

The pharmacokinetics of once-daily dosing with gentamicin in women with postpartum endometritis

Sunyecz

Wiesenfeld

Heine

1998

Infect. Dis. Obstet. Gynecol.

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Objective To evaluate the pharmacokinetics and cost of once‐daily dosing with gentamicin in women with postpartum endometritis. Methods Gentamicin in a single daily dose of 4.5 mg/kg was administered intravenously to 10 women with postpartum endometritis. Peak and trough gentamicin levels were measured, and nephrotoxicity and clinical ototoxicity were monitored. Pharmacokinetic data were analyzed, and a cost analysis of once‐daily gentamicin administration was performed. Results The mean elimination constant was 0.105 ± 0.008 L/h, and the mean volume of distribution was 0.34 ± 0.07 L/kg. Mean peak gentamicin levels exceeded 11 mg/L, and all trough levels were <0.3 mg/L. Cost savings of 44% were achieved with once‐daily dosing of gentamicin, compared with traditional thrice‐daily dosing. Conclusions Once‐daily dosing with gentamicin in women with postpartum endometritis achieves therapeutic peak levels without drug accumulation. Substantial cost savings are realized with this dosing regimen. Infect. Dis. Obstet. Gynecol. 6:160–162, 1998. © 1998 Wiley‐Liss, Inc.

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“…Only two studies have examined daily gentamicin for treatment of chorioamnionitis. 6,7 Extrapolated peak umbilical cord serum levels were closer to ideal neonatal levels when 38 women with clinical chorioamnionitis were treated with daily compared with 8-hour gentamicin. 6 Treatment efficacy was equal among a subset of 131 women with intrapartum chorioamnionitis treated with daily gentamicin and twice-daily clindamycin compared with 8-hour gentamicin and 8-hour clindamycin.…”

mentioning

confidence: 92%

“…6 Treatment efficacy was equal among a subset of 131 women with intrapartum chorioamnionitis treated with daily gentamicin and twice-daily clindamycin compared with 8-hour gentamicin and 8-hour clindamycin. 7 The bactericidal activity of aminoglycosides is concentration dependent, and the greater peak concentrations of daily gentamicin exert greater bactericidal affects in vitro, resulting in lower bacterial counts. 8 Higher aminoglycoside doses also result in a longer postantibiotic effect in vivo, defined as a persistent suppression of bacterial growth despite residual drug concentrations below the minimal inhibitory concentration; this also results in longer intervals before significant bacterial regrowth.…”

mentioning

confidence: 99%