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Fulltext Therapeutic drug monitoring for gentamicin in Hospital Universiti Sains Malaysia

Ismail R, Sarriff A, Abdul Rahman AF

Med J Malaysia, 1990 Mar;45(1):57-64.

PMID: 2152070

We evaluated the usefulness of therapeutic drug monitoring (TDM) for gentamicin and the use of a two-point peak and trough pair concentration method to adjust its dose. Of the 194 patients included, initial concentrations were appropriate in only sixty nine. In the seventy one cases of dosage adjustments using this method, those attaining therapeutic levels increased overall from 38% to 67%. It is concluded that TDM for gentamicin with dosage adjustment using this simple pharmacokinetic approach is useful and adequate in monitoring for gentamicin therapy.

Matched MeSH terms: Gentamicins/administration & dosage*

Fulltext Impact of gentamicin coadministration along with high fructose feeding on progression of renal failure and metabolic syndrome in Sprague-Dawley rats

Ibraheem ZO, Basir R, Aljobory AKh, Ibrahim OE, Alsumaidaee A, Yam MF

Biomed Res Int, 2014;2014:823879.

PMID: 25045706 DOI: 10.1155/2014/823879

The current study evaluates the impact of high fructose feeding in rat model of gentamicin induced nephrotoxicity. Sprague-Dawley rats weighing 180-200 g were randomized into four groups; (C) received standard rodents chow with free access to ad libitum drinking water for 8 weeks and was considered as control, (F) received standard rodents chow with free access to drinking water supplemented with 20% (W/V) fructose for the same abovementioned period, (FG) was fed as group F and was given 80 mg/kg (body weight)/day gentamicin sulphate intraperitoneally during the last 20 days of the feeding period, and (G) was given gentamicin as above and fed as group C. Renal function was assessed at the end of the treatment period through measuring serum creatinine, uric acid and albumin, creatinine clearance, absolute and fractional excretion of both sodium and potassium, twenty-four-hour urinary excretion of albumin, and renal histology. For metabolic syndrome assessment, fasting plasma glucose and insulin were measured and oral glucose tolerance test was performed throughout the treatment period. Results showed that gentamicin enhances progression of fructose induced metabolic syndrome. On the other hand, fructose pretreatment before gentamicin injection produced a comparable degree of renal dysfunction to those which were given fructose-free water but the picture of nephrotoxicity was somewhat altered as it was characterized by higher extent of glomerular congestion and protein urea. Overall, more vigilance is required when nephrotoxic drugs are prescribed for patients with fructose induced metabolic syndrome.

Matched MeSH terms: Gentamicins/administration & dosage*

Fulltext Local antibiotics are equivalent to intravenous antibiotics in the prevention of superficial wound infection in inguinal hernioplasty

Praveen S, Rohaizak M

Asian J Surg, 2009 Jan;32(1):59-63.

PMID: 19321405 DOI: 10.1016/S1015-9584(09)60011-7

Antibiotic prophylaxis for inguinal hernioplasty is still practiced in many hospitals to prevent consequences of infected mesh, mesh removal and hernia recurrence. The common route of administration is intravenous. However this method can be associated with systemic side effects. Alternatively, locally applied antibiotics have been used and proven to significantly reduce the infection rate after inguinal hernioplasty.

Matched MeSH terms: Gentamicins/administration & dosage*

Therapeutic drug monitoring of gentamicin: a 6-year follow-up audit

Ismail R, Haq AH, Azman M, Rahman AF

J Clin Pharm Ther, 1997 Feb;22(1):21-5.

PMID: 9292398

In 1984 a therapeutic drug monitoring (TDM) service was established in Hospital Universiti Sains Malaysia (HUSM) and gentamicin concentrations were measured and used to design optimal regimens for the antibiotic. In this study we report on a 6-year follow-up audit since our first assessment of the service.

Matched MeSH terms: Gentamicins/administration & dosage

Management of infective endocarditis in pregnancy

Jeyamalar R, Sivanesaratnam V

Aust N Z J Obstet Gynaecol, 1991 May;31(2):123-4.

PMID: 1930032

Matched MeSH terms: Gentamicins/administration & dosage

Clinical pharmacokinetics, toxicity and cost effectiveness analysis of aminoglycosides and aminoglycoside dosing services

Mathews A, Bailie GR

J Clin Pharm Ther, 1987 Oct;12(5):273-91.

PMID: 3119606

This article reviews the clinical pharmacokinetics, clinical toxicity and cost-effectiveness analysis of aminoglycosides and of dosing services for aminoglycosides. The reader is referred elsewhere for a review of the pharmacology, antimicrobial spectrum of activity and clinical use of these drugs. A critique of the more commonly used methods of aminoglycoside dosage determinations is included, based on the inter-individual variation in aminoglycoside disposition parameters. The advantages and disadvantages of arbitrary, predictive, and pharmacokinetic methods of dosing determination are summarized. Justification for the routine determination of serum aminoglycoside concentrations is reviewed. We review the lack of standardization of definitions for aminoglycoside-associated nephrotoxicity in published studies, and studies which illustrate these differences are highlighted. Evidence for the association between serum aminoglycoside concentrations and nephrotoxicity is examined. Ototoxicity is similarly reviewed. The concept of cost-effectiveness analysis is examined extensively in this review. We discuss the literature concerning the cost benefit analysis of drug dosing services.

Matched MeSH terms: Gentamicins/administration & dosage

Gentamicin administration via peritoneal dialysis fluid: the risk of ototoxicity

Gendeh BS, Said H, Gibb AG, Aziz NS, Zahir ZM

J Laryngol Otol, 1991 Dec;105(12):999-1001.

PMID: 1787382

In a prospective study on 47 patients, 16 mg of gentamicin per two litres dialysate was administered intraperitoneally at every cycle of intermittent peritoneal dialysis, carried out over the course of several days. Serum gentamicin sampling, pure tone audiometry and caloric tests were performed before and during the treatment. The gentamicin levels reached at the end of the thirtieth cycle were observed to be low. In view of this, the risk of acute ototoxicity was considered to be minimal. This was confirmed by the absence of clinical audiometric or vestibulometric evidence of toxicity.

Matched MeSH terms: Gentamicins/administration & dosage

Estimating drug-free period using a graphical method: an alternative way to monitor extended-interval dosing of gentamicin therapy

Ab Rahman AF, Md Sahak N, Ali AM

Int J Pharm Pract, 2017 Feb;25(1):75-80.

PMID: 28097717 DOI: 10.1111/ijpp.12336

OBJECTIVES: Published nomograms to monitor extended-interval dosing (EID) gentamicin therapy were based on a fixed dose of 5 or 7 mg/kg. However, the average dose used for EID gentamicin regimen in our setting was about 3 mg/kg per day. We developed a new method of monitoring based on the duration of drug-free period (DFP) in a 24-h dosing interval.

METHODS: Hospitalised adult patients on EID gentamicin were selected. We considered a DFP of between 2 and 8 h as appropriate. Data from two blood samples (2 and 6 h postdose) from each patient were used to estimate the duration of DFP (i.e. DFP method 1). DFP was also calculated for the same patient using an empirically estimated elimination rate constant (Ke ) and the same 6 h postdose concentration value (DFP method 2). Correlation between the two methods was made. An alternative graphical method to estimate DFP was attempted.

KEY FINDINGS: Correlation between Ke and age was favourable (r = -0.453; P = 0.001). Ke derived from this empirical relationship was used to estimate DFP method 2. DFP method 1 correlated well with DFP method 2 (r = 0.742; P

Matched MeSH terms: Gentamicins/administration & dosage*

Fulltext Use of gentamicin impregnated POP discs for antibiotic pouch dressing

Lau CP, Chee EK, Thirumal M

Med J Malaysia, 2006 Dec;61 Suppl B:32-6.

PMID: 17600990

Antibiotic pouch technique is commonly used due to the high local antibiotic concentration and moist environment for wound healing. We used locally made gentamicin impregnated Plaster of Paris discs in treating wounds with exposed deep structures like tendons and bones. Out of 22 patients treated with this method, 19 completed treatment. Granulation tissue formed quickly and effectively covered the exposed structures. All wounds either healed by secondary intention or became suitable for split skin grafting. Gentamicin impregnated Plaster of Paris disc pouch dressing is safe, cost saving, and effective for management of deep open wounds.

Matched MeSH terms: Gentamicins/administration & dosage

Transcription profile of genes affected in response to pathological changes in drug-induced rat model of acute kidney injury

Habib R, Begum S, Alam G, Ali A, Khan I, Waseem M, et al.

Ren Fail, 2015 Aug;37(7):1225-31.

PMID: 26114661 DOI: 10.3109/0886022X.2015.1057801

The objective of the present study was to examine the changes in the expression profile of certain genes in rat model of gentamicin-induced acute kidney injury (AKI) and to see whether time period and routes of administration affect their expression levels.

Matched MeSH terms: Gentamicins/administration & dosage*

Providing guidelines and education is not enough: an audit of gentamicin use at The Royal Melbourne Hospital

Leong CL, Buising K, Richards M, Robertson M, Street A

Intern Med J, 2006 Jan;36(1):37-42.

PMID: 16409311

BACKGROUND: Aminoglycoside antibiotics are commonly prescribed for the treatment of Gram-negative infections. Appropriate dosing and therapeutic monitoring of aminoglycosides are important because these agents have a narrow therapeutic index.
AIM: To audit gentamicin use at our hospital, focusing on selection of the initial dose and therapeutic monitoring practices, and to compare the results against recommendations in the existing hospital aminoglycoside guidelines, which had recently been promoted to doctors.
METHODS: This audit included all inpatients receiving gentamicin at The Royal Melbourne Hospital from 1 February to 12 March 2004. The principal researcher checked the drug charts of all inpatients to identify those receiving gentamicin and collected data from the medical records and the pathology database. Doses were considered 'concordant' if the dose given was within the recommended dosing range +/-20 mg.
RESULTS: A total of 132 courses of gentamicin was included in the study. Gentamicin was prescribed for prophylaxis in 31.1% of courses. Thirty-six per cent of patients prescribed gentamicin were more than 65 years of age. Eighty-two per cent of the gentamicin used therapeutically was given as a single daily dose. Sixty-six per cent of gentamicin initial dosing was not in accordance with existing hospital guidelines. Seventy-seven per cent of gentamicin courses requiring therapeutic drug monitoring received such monitoring; however, in only 8.8% of these was the monitoring conducted according to guidelines.
CONCLUSION: Aminoglycoside prescribing practices at our hospital are suboptimal, despite ready access to prescribing guidelines. Provision of a guideline and education sessions with doctors do not necessarily lead to widespread adoption of recommended practices. We suggest that changes to hospital systems related to prescribing and monitoring of aminoglycosides are required.

Matched MeSH terms: Gentamicins/administration & dosage

Fulltext Shewanella algae Peritonitis in Patients on Peritoneal Dialysis

Shanmuganathan M, Goh BL, Lim C, NorFadhlina Z, Fairol I

Perit Dial Int, 2016 9 24;36(5):574-5.

PMID: 27659933 DOI: 10.3747/pdi.2015.00287

Patients with peritonitis present with abdominal pain, diarrhea, fever, and turbid peritoneal dialysis (PD) fluid. Shewanella algae peritonitis has not yet been reported in PD patients in the literature. We present the first 2 cases of Shewanella algae peritonitis in PD patients. Mupirocin cream is applied on the exit site as prophylactic antibiotic therapy.

Matched MeSH terms: Gentamicins/administration & dosage

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