Gentamicin dosing in postpartum women with endometritis

Postpartum women receiving gentamicin for endometritis were studied to determine if selective determination of gentamicin serum levels was cost-effective in terms of safety and efficacy. The women were randomized into two groups of 30 patients each. In the control group gentamicin serum levels were determined after the third dose. In the study group, levels were determined only if renal dysfunction was evident or if the patient failed to respond to therapy. Determination of serum levels did not assure a better therapeutic outcome in either group, as measured by hospital stay, duration of treatment, total cost of antibiotics, and hospital readmissions. Although pharmacokinetic dosing equations were used, the use of 1.75 mg/kg every 8 hours based on actual body weight in patients with average heights and weights would have produced acceptable results. We conclude that routine monitoring of gentamicin serum levels is not required in otherwise healthy postpartum women with endometritis.