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Updated: May 22, 2026

Transdermal Measurement of Glomerular Filtration Rate in Mechanically Ventilated Piglets
Published on: September 13, 2022
Gentamicin pharmacokinetics during continuous venovenous hemofiltration in critically ill septic patients
Nadezda Petejova1, Jana Zahalkova, Jana Duricova
1Department of Internal Medicine, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Czech Republic. jankaduricova82@gmail.com
Objective:
Current dosing recommendations for administration of gentamicin to septic patients with acute kidney injury (AKI) on continuous venovenous hemofiltration (CVVH) at a filtration rate of 45 ml/kg/h are missing.
Aim:
To describe gentamicin pharmacokinetics and to find an optimal dosing regimen in patients on CVVH.
Methods:
Seven adult patients were included. Patients received loading dose of 240 mg followed by application of maintenance dose every 24 hours. Maintenance dose was adjusted according to gentamicin C(max)/MIC ratio and drug levels simulation using a pharmacokinetic programme.
Results:
Median total clearance (0.59-0.79 ml/min/kg) was similar to patients with normal renal function; median volume of distribution was higher than observed in non-septic patients (about 0.5 l/kg versus 0.25 l/kg). Patients with diuresis required an increase of gentamicin dose to reach C(max)/MIC ratio.
Conclusion:
Septic patients with AKI on CVVH (45 ml/kg/h) require a loading dose of 240 mg, followed by therapeutic drug monitoring to optimize maintenance dose.
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