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Patient selection for serum gentamicin levels.

V Lampasona, R E Crass

    Therapeutic Drug Monitoring
    |January 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

    Developing criteria for serum gentamicin level (SGL) testing improved patient selection. However, many patients meeting criteria still did not receive necessary SGL monitoring, highlighting a need for increased clinical awareness.

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    Area of Science:

    • Pharmacokinetics and Therapeutics
    • Clinical Pharmacy Practice

    Background:

    • Gentamicin, a widely used aminoglycoside antibiotic, requires therapeutic drug monitoring due to its narrow therapeutic index.
    • Existing literature on gentamicin pharmacokinetics and elimination factors is extensive but requires synthesis for clinical application.
    • Appropriate selection for serum gentamicin level (SGL) determination is crucial for optimizing efficacy and minimizing toxicity.

    Purpose of the Study:

    • To develop and validate criteria for appropriate patient selection for serum gentamicin level (SGL) determinations.
    • To assess the concordance between established criteria and actual clinical practice in SGL monitoring.
    • To identify gaps in clinician awareness regarding factors influencing gentamicin therapy.

    Main Methods:

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  • A critical literature review was conducted to identify factors influencing gentamicin pharmacokinetics and elimination.
  • Criteria for appropriate SGL determination were generated based on the literature review.
  • Prospective evaluation of 73 patients at a university hospital using the developed criteria to assess sampling appropriateness.

    • Main Results:

    • Of 73 patients evaluated, 67.2% were appropriately selected for SGL measurement.
    • 54.8% of patients met at least one criterion for SGL determination.
    • Only 40% of patients who met the criteria actually received SGL measurements, indicating a significant gap.

    Conclusions:

    • The developed criteria can aid in selecting patients for SGL monitoring.
    • Despite appropriate patient selection, underutilization of SGL testing among eligible patients was observed.
    • Enhanced clinician awareness of factors leading to toxic or subtherapeutic gentamicin levels is necessary.