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Gentamicin as Empirical Treatment in Hemodialysis Patients: Safety, Pharmacokinetics, and Pharmacodynamics
Author(s) -
GuisadoGil Ana B,
HerreraHidalgo Laura,
SantosRubio María D,
GilSacaluga Luis,
Molina José,
LepeJiménez José A,
CamachoMartínez Pedro,
GilNavarro María V
Publication year - 2019
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12810
Subject(s) - medicine , gentamicin , pharmacodynamics , pharmacokinetics , nephrotoxicity , aminoglycoside , hemodialysis , population , ototoxicity , pharmacology , adverse effect , antibiotics , intensive care medicine , kidney , chemotherapy , microbiology and biotechnology , cisplatin , environmental health , biology
The aim of this study was to describe the safety profile and pharmacokinetic/pharmacodynamic parameters in end‐stage renal disease patients who received gentamicin as empirical treatment in catheter‐related bacteremia when they showed infection signs, regardless of the timing of the next HD. Patients received gentamicin 3 mg/kg before blood culture extraction when they showed infection signs and regardless of the timing of next hemodialysis session. Serum concentrations were collected after the gentamicin administration (peak level) and before the next HD (trough level). Toxicities and adverse drug events were registered. The main pharmacokinetic/pharmacodynamic goal for Gram‐negative infections was peak:minimum inhibitory concentration (MIC) ≥10. Sixteen patients were included. Nephrotoxicity was not assessed in this population, and no ototoxicity was found. According to microbial isolation and gentamicin susceptibility, the value of peak:MIC was 5.4 ± 2.0. The administration of gentamicin in these conditions was safe. Estimated pharmacokinetic values were consistent with previous studies and appropriate according to peak:MIC goal for Gram‐negative organisms with MIC ≤1 mg/L.