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Short-term gentamicin therapy and risk of renal toxicity in patients with bacteraemia

Marianne H Spanggaard1, Bo L Hønge, Henrik C Schønheyder

  • 1Department of Infectious Diseases, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.

Scandinavian Journal of Infectious Diseases
|August 27, 2011
PubMed

Insights

Short-term gentamicin (≤ 5 days) administration did not increase renal impairment risk in patients with community-acquired bacteremia. Renal safety was similar between gentamicin-exposed and non-exposed groups, indicating no significant difference in kidney function.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Gentamicin's renal safety is a concern, particularly with once-daily dosing.
  • Previous studies have raised questions about potential kidney damage from gentamicin.

Purpose of the Study:

  • To evaluate the renal safety of short-term, once-daily gentamicin in adult patients with community-acquired bacteremia.
  • To compare the incidence of renal impairment between gentamicin-exposed and non-exposed patient groups.

Main Methods:

  • Retrospective cohort study of adult patients with community-acquired bacteremia.
  • Inclusion criteria: no chronic renal disease or malignancy, gentamicin treatment ≤ 5 days (n=165) or no aminoglycosides (n=150).
  • Primary endpoint: plasma creatinine elevation > 40 μmol/l from baseline; secondary endpoint: 30-day mortality.

Main Results:

  • Elevated creatinine occurred in 7.9% of gentamicin-exposed patients versus 8.7% of non-exposed patients (p=0.80).
  • Follow-up creatinine normalized in 67% of exposed and 78% of non-exposed patients with elevated creatinine (p=0.66).
  • 30-day mortality was 7.9% for exposed and 7.3% for non-exposed patients (p=0.86).

Conclusions:

  • Short-term (≤ 5 days) gentamicin administration is not associated with increased renal impairment in bacteremic patients.
  • Renal impairment in this context appears independent of gentamicin use.
  • Gentamicin can be considered safe for short-term use in this patient population regarding renal function.

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