Safety of Gentamicin Bladder Irrigations in Complex Urological Cases

DeFoor, William; Ferguson, Denise; Mashni, Susan M.; Creelman, Lisa; Reeves, Deborah; Minevich, Eugene; Reddy, Pramod; Sheldon, Curtis A.

doi:10.1016/s0022-5347(05)00928-6

Cited by 46 publications

(42 citation statements)

References 11 publications

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“…Compared with previous studies, the dosage (80 mg) used was considerably higher [6,16,18]. This may have been overtreatment, but based on the literature review we can conclude that the optimal dosage remains unclear.…”

Section: Discussionmentioning

confidence: 63%

“…Pearman [14] stated that haematuria or other clinical evidence of chemical cystitis did not occur in any of the patients who received kanamycin/colistin instillations. None of the children investigated had detectable gentamicin serum levels [6,18]. Small increases in serum creatinine levels were observed in 3 of 80 children evaluated by Defoor et al [18], but this was ascribed to underlying renal disease; no side effects, allergic reactions or clinical toxicities were documented.…”

Section: Safety Of Intravesical Aminoglycosidementioning

confidence: 81%

“…Breakthrough UTI occurred in 26% of the children examined by Defoor et al [18]. All those were on low-dose gentamicin (14.4 mg once daily), suggesting that a higher dosage of gentamicin is required to prevent UTI [18].…”

Section: Efficacy Of Intravesical Aminoglycosidementioning

confidence: 97%

“…Two studies included children with neurogenic bladder and gentamicin bladder instillations [6,18]. Both were case series that indicated a reduction of bacteriuria and UTI with intravesical gentamicin.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All those were on low-dose gentamicin (14.4 mg once daily), suggesting that a higher dosage of gentamicin is required to prevent UTI [18].…”

Section: Efficacy Of Intravesical Aminoglycosidementioning

confidence: 99%

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Intravesical gentamicin for recurrent urinary tract infection in patients with intermittent bladder catheterisation

Nieuwkoop

Exter

Elzevier

et al. 2010

International Journal of Antimicrobial Agents

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Clean intermittent catheterisation (CIC) of the bladder is used to imitate normal bladder emptying in patients with bladder dysfunction. CIC is associated with urinary tract infection (UTI) that may be difficult to treat in the case of antimicrobial resistance. The aim of this study was to establish the effect and safety of intravesical gentamicin treatment in such settings. In 2009, intravesical gentamicin treatment was started in selected patients. Here we describe our experience with two patients treated until March 2010. Two patients using CIC suffering recurrent UTI with multiresistant Escherichia coli were treated with daily administration of 80 mg intravesical gentamicin. On treatment they appeared asymptomatic. During 8-and 9-month follow-up they were free of UTI, urine cultures were negative and there were no side effects. A systematic review was conducted through searches of PubMed and other databases. Clinical trials that met the eligibility criteria and displayed the efficacy or safety of intravesical aminoglycoside treatment in patients using CIC were studied. Study selection was performed by two independent reviewers. Eight studies were included for review. Owing to study heterogeneity, a meta-analysis could not be performed. Of four controlled studies using neomycin or kanamycin, two demonstrated a significant reduction in bacteriuria, whilst two other trials did not. One case series on neomycin/polymyxin showed that the majority of patients still developed bacteriuria. Three case series using gentamicin all pointed towards a significant reduction in bacteriuria and UTIs. There were no clinically relevant side effects reported but follow-up in all studies was limited. Although data are limited, intravesical treatment with gentamicin might be a reasonable treatment option in selected patients practicing CIC who suffer recurrent UTIs with highly resistant microorganisms.

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Section: Discussionmentioning

confidence: 63%

Section: Safety Of Intravesical Aminoglycosidementioning

confidence: 81%

Section: Efficacy Of Intravesical Aminoglycosidementioning

confidence: 97%

Section: Study Characteristicsmentioning

confidence: 99%

“…All those were on low-dose gentamicin (14.4 mg once daily), suggesting that a higher dosage of gentamicin is required to prevent UTI [18].…”

Section: Efficacy Of Intravesical Aminoglycosidementioning

confidence: 99%

See 3 more Smart Citations

Intravesical gentamicin for recurrent urinary tract infection in patients with intermittent bladder catheterisation

Nieuwkoop

Exter

Elzevier

et al. 2010

International Journal of Antimicrobial Agents

View full text Add to dashboard Cite

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Is That Solution for IV or Irrigation? Fluid Administration Errors in the Operating Room

2021

AORN Journal

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Clinical Pharmacogenetics Implementation Consortium Guideline for the Use of Aminoglycosides Based on MT‐RNR1 Genotype

McDermott

Wolf

Hoshitsuki

et al. 2021

Clin Pharma and Therapeutics

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Aminoglycosides are widely used antibiotics with notable side effects, such as nephrotoxicity, vestibulotoxicity, and sensorineural hearing loss (cochleotoxicity). MT-RNR1 is a gene that encodes the 12s rRNA subunit and is the mitochondrial homologue of the prokaryotic 16s rRNA. Some MT-RNR1 variants (i.e., m.1095T>C; m.1494C>T; m.1555A>G) more closely resemble the bacterial 16s rRNA subunit and result in increased risk of aminoglycosideinduced hearing loss. Use of aminoglycosides should be avoided in individuals with an MT-RNR1 variant associated with an increased risk of aminoglycoside-induced hearing loss unless the high risk of permanent hearing loss is outweighed by the severity of infection and safe or effective alternative therapies are not available. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for the use of aminoglycosides based on MT-RNR1 genotype (updates at https://cpicp gx.org/guide lines/ and www.pharm gkb.org).

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Safety of Gentamicin Bladder Irrigations in Complex Urological Cases

Abstract: Gentamicin bladder irrigations are a helpful adjunct in the management of complex pediatric urological cases involving recurrent symptomatic bacteriuria. We no longer require intensive laboratory monitoring of low risk patients at our institution.

Cited by 46 publications

References 11 publications

Intravesical gentamicin for recurrent urinary tract infection in patients with intermittent bladder catheterisation

Intravesical gentamicin for recurrent urinary tract infection in patients with intermittent bladder catheterisation

Is That Solution for IV or Irrigation? Fluid Administration Errors in the Operating Room

Clinical Pharmacogenetics Implementation Consortium Guideline for the Use of Aminoglycosides Based on MT‐RNR1 Genotype

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