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

OBJECTIVE: We compared the pharmacokinetics of two methods for dosing gentamicin for the treatment of postpartum endometritis with the goal of achieving adequate peak serum concentrations (>12 mg/L) and prolonged trough levels below 2 mg/L. METHODS: Group-I subjects (n = 5) received intravenous gentamicin, 5 mg/kg per total body weight over 60 min., with a maximum dose of 500 mg. Group-II subjects (n = 17) were dosed intravenously according to the following formula: Dose = desired peak concentration (fixed at 14 mg/L) * (volume of distribution, i.e., 0.35 L/kg) * adjusted body weight (in kilograms). Serum gentamicin levels were obtained 1 hr. and 8-12 hr. after infusion of the second dose. Pharmacokinetic parameters for the subjects in each group were calculated according to standard formulas. RESULTS: Subjects in Group I had significantly higher doses and peak drug concentrations (P < 0.01), while in Group II, 76% of patients had peak levels less than desired (<12 mg/L). Both groups maintained trough levels of <2 mg/L in excess of 12 hr. CONCLUSIONS: Changing to the adjusted body weight formula for Group I, while maintaining a dose between 4 and 5 mg/kg, would reduce excessive peak concentrations. Using a calculated volume of distribution of 0.4 L/kg in Group II would improve peak serum concentrations to the desired levels. Both dosing regimens ensure adequate aminoglycoside pharmacokinetic parameters and avoid the need for monitoring serial serum drug concentrations, provided the expected clinical response is also achieved. While the first dosing formula is simpler to calculate, the second dosing formula allows for more individualized dosing considerations.

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Single daily dosing of gentamicin: Pharmacokinetic comparison of two dosing methodologies for postpartum endometritis

Liu

Abate

Reyes

et al. 1999

Infect. Dis. Obstet. Gynecol.

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Pelvic inflammatory disease: new diagnostic criteria and treatment

Beigi

Wiesenfeld

2003

Obstetrics and Gynecology Clinics of North America

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Inhibitory Effects of Grape Seeds Powder, Extract and Oil on Gentamicin Induced Nephrotoxicity in Rats

Nagib

2014

Egyptian Journal of Nutrition and Health

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This study was designed to determine the Inhibitory effect of grape seeds powder, extract and oil on gentamicin-induced nephrotoxicity in rats.The study was carried out on 30 adult albino male rats Sprague-Dawley strain were classified into two groups: The first group (n= 6) left as normal control group(-ve), fed on basal diet, the second group(n= 24) injected with gentamicin (100 mg/kg/day for 7 days i.p). These animals were divided into 4 groups 6 rats each of these , control (+ve) group and 3 groups were treated with grape seeds powder ( 10 % of diet ) , grape seeds extract (300mg/kg b.w.orally by stomach tube) and grape seeds oil (4 ml/kg b.w. orally by stomach tube) respectively.The treatment period was designed for eight weeks. The results revealed that, Gentamicin injection induced marked nephrotoxicity as evidenced by significant elevation in serum levels of creatinine, urea, uric acid, A/G ratio, MDA ,renin hormone, phosphorus and potassium, with significant reduction in serum levels of total protein, albumin, globulin, (SOD), (GPX), (GST) ,catalase antioxidant enzymes, erythropoietin hormone (EPO) , vitamin D and Ca . While the rat groups treated with grape seeds powder ,extract and oil showed significant improvement of the levels of serum total protein, albumin, globulin, kidney tissue superoxide dismutase (SOD), glutathione peroxidase (GPX), glutathione transferase (GST) , catalase antioxidant enzymes, erythropoietin hormone (EPO) and vitamin D, and significant decrease in serum creatinine, urea, uric acid, albumin/globulin ratio ,kidney tissue malondialdehyde (MDA), renin hormone, phosphorus and potassium compared with control(+ve) group. In conclusion, feeding rats with grape seeds powder ,extract and oil may significantly reduce nephrotoxicity, So this study recommend the use of grape seeds especially grape seeds oil or grape seeds extract for humans suffering nephrotoxicity, could be of value.

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

Cited by 3 publications

References 14 publications

Single daily dosing of gentamicin: Pharmacokinetic comparison of two dosing methodologies for postpartum endometritis

Single daily dosing of gentamicin: Pharmacokinetic comparison of two dosing methodologies for postpartum endometritis

Pelvic inflammatory disease: new diagnostic criteria and treatment

Inhibitory Effects of Grape Seeds Powder, Extract and Oil on Gentamicin Induced Nephrotoxicity in Rats

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