Open AccessRisk Factors for Toxicity in Elderly Patients Given Aminoglycosides Once Daily
Author(s) -
Paterson David L.,
Robson Jennifer M.B.,
Wagener Marilyn M.
Publication year - 1998
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1046/j.1525-1497.1998.00224.x
Subject(s) - medicine , aminoglycoside , nephrotoxicity , toxicity , creatinine , prospective cohort study , risk factor , intensive care medicine , antibiotics , microbiology and biotechnology , biology
OBJECTIVE: To determine the risk factors for aminoglycoside toxicity in the elderly. DESIGN: Prospective observational study. SETTING: Acute care teaching hospital serving predominantly veterans. PARTICIPANTS: Consecutive patients aged 70 years and over receiving aminoglycosides. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Thirteen (15%) of 88 patients developed aminoglycoside‐related nephrotoxicity and 3 (3.4%) developed otovestibular toxicity. Multivariate analysis showed that increasing duration of aminoglycoside therapy was the only factor significantly associated with development of toxicity. Elevated baseline serum creatinine level ( p = .02) and use of allopurinol ( p = .03) were risk factors specifically for nephrotoxicity. Only 2 (3.9%) of 51 patients receiving aminoglycosides 7 or fewer days developed nephrotoxicity, as compared with 11 (30%) of 37 receiving the drugs for 8 to 14 days and 4 (50%) of 8 treated for more than 14 days. CONCLUSIONS: Although toxicity is common in elderly patients treated with aminoglycosides, limiting the duration of aminoglycoside therapy to less than a week can substantially reduce risk of toxicity.