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Published on: August 30, 2018
Recommended gentamicin peak plasma levels rarely reached, even with recommended dosages
Quentin Perrier1, Anne-Flore Dumas2, Hélène Pluchart2
1Université Grenoble Alpes, INSERM, LBFA, U1055, Pharmacy Department, Grenoble Alpes University Hospital, Grenoble, France.
Introduction:
The recommended gentamicin peak plasma concentration range is 32-40 mg/L; we aimed to determine how frequently it was reached, and for which gentamicin doses.
Patients And Methods:
We retrospectively reviewed 601 gentamicin peak plasma concentrations in 501 patients aged ≥15 in our institution between 2013 and 2023.
Results:
Median gentamicin dose was 5.9 mg/kg [IQR 4.1-7.9]. Median peak plasma concentration was 16.5 mg/L [IQR 10.8-22.8] and was strongly correlated with dose (p < 0.0001). Only 5.7 % of values were ≥32 mg/L, including 22.8 % for dose ≥10 mg/kg.
Conclusion:
This suggests that existing recommendations regarding either dose or target concentration for gentamicin should be modified.
Insights
Most patients did not achieve the recommended gentamicin peak plasma concentration (32-40 mg/L). Gentamicin dosing and target concentrations may require adjustment to improve therapeutic efficacy.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Nephrology
Background:
- The established therapeutic range for gentamicin peak plasma concentration is 32-40 mg/L.
- Current gentamicin dosing strategies may not consistently achieve these target concentrations.
Purpose of the Study:
- To evaluate the frequency of achieving recommended gentamicin peak plasma concentrations.
- To identify optimal gentamicin doses for reaching therapeutic targets.
Main Methods:
- Retrospective review of 601 gentamicin peak plasma concentrations.
- Analysis of data from 501 patients aged 15 years or older (2013-2023).
Main Results:
- Median gentamicin dose was 5.9 mg/kg, with a median peak concentration of 16.5 mg/L.
- Only 5.7% of patients reached the target peak concentration of ≥32 mg/L.
- A dose of ≥10 mg/kg was associated with achieving the target in 22.8% of cases.
Conclusions:
- Current gentamicin dosing and target concentration recommendations may need revision.
- Further studies are warranted to optimize gentamicin therapy and minimize subtherapeutic levels.
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