Comparison of once-daily versus pharmacokinetic dosing of aminoglycosides in elderly patients

Koo, Ji M.; Tight, Robert R.; Rajkumar, Vincent; Hawa, Zafir

doi:10.1016/s0002-9343(96)80074-x

Cited by 49 publications

(32 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, the mean steady state of the trough concentrations were statistically significantly lower in the ODD subgroup in amikacin group (P-value = 0.034), but statistically insignificantly lower in the gentamicin group (P-value > 0.05), possibly due to the small number of patients. The previously mentioned results are in accordance with those obtained by Prins et al (1993) who studied once versus thrice daily gentamicin dosing in patients with serious infections, Raz et al (1995) who studied intravenous administration of gentamicin once daily versus thrice daily in adults, and Jikoo et al (1996) who compared once daily versus pharmacokinetic dosing of gentamicin or tobramycin in elderly male patients. The previously mentioned three studies reported that the mean trough levels of gentamicin were lower and the mean peak levels were higher in the ODD subgroup.…”

Section: Discussionsupporting

confidence: 85%

“…Serum aminoglycoside level determination was determined using enzyme multiplied immunoassay technique (EMIT) using the Vitalab VIVA analyzer (Syva Company, Dade Behring Inc., USA) (Mendu et al, 2007;Nishihara, 1995). The sampling intervals include; 30 min after end of infusion of the third dose, half of the dosing interval between the third and fourth dose, and 15-30 min just before the fourth dose (Dorman et al, 1998;Huber, 1996;Jikoo et al, 1996). These intervals were chosen to ensure that the drug had reached steady state concentration.…”

Section: Serum Aminoglycoside Level Determinationmentioning

confidence: 99%

“…Nephrotoxicity was defined as an increase in serum creatinine of P0.5 mg/dl at any time during treatment or up to 1 week after stopping treatment (Jikoo et al, 1996). Patients who had been treated with amphotericin B, frusemide over 160 mg daily or vancomycin were not evaluable for toxicity.…”

Section: Evaluation Of Nephrotoxicitymentioning

confidence: 99%

See 2 more Smart Citations

Once versus individualized multiple daily dosing of aminoglycosides in critically ill patients

Abdel-Bari

Mokhtar

Sabry

et al. 2011

Saudi Pharmaceutical Journal

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Serum Aminoglycoside Level Determinationmentioning

confidence: 99%

See 1 more Smart Citation

Once versus individualized multiple daily dosing of aminoglycosides in critically ill patients

Abdel-Bari

Mokhtar

Sabry

et al. 2011

Saudi Pharmaceutical Journal

View full text Add to dashboard Cite

show abstract

“…In an analysis of 1,489 patients treated with an aminoglycoside, baseline renal dysfunction was identified as a risk factor for nephrotoxicity in the univariate analysis, but this was not confirmed in the multiple logistic regression analysis (5). Two different studies assessing aminoglycoside-associated nephrotoxicity in 96 and 249 patients, respectively, did not recognize the initial serum creatinine level or a decreased GFR as a risk factor for kidney injury in the logistic regression analysis (13,29). Finally, a higher initial creatinine clearance rate was associated with an increased risk of nephrotoxicity.…”

Section: Discussionmentioning

confidence: 98%

Prevalence and Risk Factors for Aminoglycoside Nephrotoxicity in Intensive Care Units

Oliveira

Silva

Barbieri

et al. 2009

Antimicrob Agents Chemother

154

View full text Add to dashboard Cite

In order to assess the prevalence of and risk factors for aminoglycoside-associated nephrotoxicity in intensive care units (ICUs), we evaluated 360 consecutive patients starting aminoglycoside therapy in an ICU. The patients had a baseline calculated glomerular filtration rate (cGFR) of >30 ml/min/1.73 m 2 . Among these patients, 209 (58%) developed aminoglycoside-associated nephrotoxicity (the acute kidney injury [AKI] group, which consisted of individuals with a decrease in cGFR of >20% from the baseline cGFR), while 151 did not (non-AKI group). Both groups had similar baseline cGFRs. The AKI group developed a lower cGFR nadir (45 ؎ 27 versus 79 ؎ 39 ml/min/1.73 m 2 for the non-AKI group; P < 0.001); was older (56 ؎ 18 years versus 52 ؎ 19 years for the non-AKI group; P ‫؍‬ 0.033); had a higher prevalence of diabetes (19.6% versus 9.3% for the non-AKI group; P ‫؍‬ 0.007); was more frequently treated with other nephrotoxic drugs (51% versus 38% for the non-AKI group; P ‫؍‬ 0.024); used iodinated contrast more frequently (18% versus 8% for the non-AKI group; P ‫؍‬ 0.0054); and showed a higher prevalence of hypotension (63% versus 44% for the non-AKI group; P ‫؍‬ 0.0003), shock (56% versus 31% for the non-AKI group; P < 0.0001), and jaundice (19% versus 8% for the non-AKI group; P ‫؍‬ 0.0036). The mortality rate was 44.5% for the AKI group and 29.1% for the non-AKI group (P ‫؍‬ 0.0031). A logistic regression model identified as significant (P < 0.05) the following independent factors that affected aminoglycoside-associated nephrotoxicity: a baseline cGFR of <60 ml/min/1.73 m 2 (odds ratio [OR], 0.42), diabetes (OR, 2.13), treatment with other nephrotoxins (OR, 1.61) or iodinated contrast (OR, 2.13), and hypotension (OR, 1.83). In conclusion, AKI was frequent among ICU patients receiving an aminoglycoside, and it was associated with a high rate of mortality. The presence of diabetes or hypotension and the use of other nephrotoxic drugs and iodinated contrast were independent risk factors for the development of aminoglycoside-associated nephrotoxicity.

show abstract

“…The aminoglycoside gentamicin is commonly used to treat gram-negative infections and continues to be widely applied in hospitalized patients [1,2] . However, the occurrence of nephrotoxicity and ototoxicity in a significant number of patients has been the main drawback [3,4] .…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Drug Monitoring of Gentamicin: Evaluation of Five Nomograms for Initial Dosing at Al-Amiri Hospital in Kuwait

Al-Lanqawi

Capps²,

Abdel-Hamid³

et al. 2007

Med Princ Pract

View full text Add to dashboard Cite

Objective: To compare five published nomograms (Thomson guidelines, Mawer nomogram, rule of eights, Hull-Sarubbi table and Dettli method) for calculating the initial gentamicin dosage regimen in a Kuwaiti population. Materials and Methods: Based on measured peak and trough gentamicin concentrations, the elimination rate constant and volume of distribution of gentamicin were calculated for each patient (n = 56), using a modified two-point Sawchuk-Zaske method. The calculated individual set of pharmacokinetic parameters and the initial dose regimen recommended by each of the five methods were used to predict the steady-state peak and trough of gentamicin concentrations. Results: The Thomson guidelines produced consistent results in predicting gentamicin concentrations within the target ranges of peak plus trough, peak only and trough only (63, 75 and 75%, respectively). The Mawer nomogram, Hull-Sarubbi table and Dettli methods achieved similar percentages of patients (46–50%) within the target ranges (5–10 mg · l^–1 for peak and 0.5–2 for trough), whereas empirical dosing and the rule of eights showed the lowest percentages of patients within the peak plus trough target range (25 and 37%, respectively). However, with respect to the underdosing target range (predicted concentration <5 mg · l^–1), the Thomson guidelines showed that 21% of patients were underdosed. Conclusion: The results show that a large number of patients (37–63%) were outside the target ranges in all initial gentamicin dosing methods evaluated in this study. Therefore, serum concentration measurement can be advised to assist in the optimization of gentamicin dose selection.

show abstract

Comparison of once-daily versus pharmacokinetic dosing of aminoglycosides in elderly patients

Cited by 49 publications

References 23 publications

Once versus individualized multiple daily dosing of aminoglycosides in critically ill patients

Once versus individualized multiple daily dosing of aminoglycosides in critically ill patients

Prevalence and Risk Factors for Aminoglycoside Nephrotoxicity in Intensive Care Units

Therapeutic Drug Monitoring of Gentamicin: Evaluation of Five Nomograms for Initial Dosing at Al-Amiri Hospital in Kuwait

Contact Info

Product

Resources

About