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Nephrotoxicity induced by gentamicin and amikacin
The Johns Hopkins Medical Journal
|March 1, 1978
Summary
Gentamicin and amikacin can cause kidney damage (nephrotoxicity) in 10.5% of patients, often appearing late in treatment. Higher drug levels and longer treatment durations increase the risk of this serious side effect.
Area of Science:
- Nephrology
- Pharmacology
- Clinical Medicine
Background:
- Aminoglycoside antibiotics like gentamicin and amikacin are crucial for treating severe bacterial infections.
- However, their use is limited by the risk of nephrotoxicity, a significant concern in patient care.
Purpose of the Study:
- To evaluate the incidence and characteristics of nephrotoxicity associated with gentamicin and amikacin therapy.
- To identify host and drug factors influencing the development of aminoglycoside-induced nephrotoxicity.
Main Methods:
- A cohort of 124 patients receiving gentamicin or amikacin therapy was monitored for signs of nephrotoxicity.
- Creatinine levels, drug peak and valley concentrations, treatment duration, and patient demographics were analyzed.
Main Results:
- The incidence of definite nephrotoxicity was 10.5%, with creatinine increases observed even after drug cessation.
- Nephrotoxicity was more frequent in patients treated for longer than 11 days (p < .01).
- Specific peak levels of amikacin (≥38.5 μg/mL) or gentamicin (≥10 μg/mL), and elevated amikacin valley levels (>10 μg/mL) were associated with increased risk (p < .025).
Conclusions:
- Gentamicin and amikacin can cause significant nephrotoxicity, characterized by delayed onset and persistent creatinine elevation.
- Treatment duration and specific drug concentration thresholds are critical factors in predicting and potentially preventing aminoglycoside-induced kidney injury.