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Clinical nephrotoxicity of tobramycin and gentamicin. A prospective study
Abstract:
Nearly 3.2 million people in this country receive aminoglycoside antibiotics annually. Gentamicin sulfate and tobramycin sulfate continue to demonstrate ototoxicity and nephrotoxicity in both animal and clinical studies. In this study, 62 patients with confirmed initial normal renal function and treated with 2 to 5 mg/kg/day of gentamicin sulfate or tobramycin sulfate for a minimum of seven days were followed up prospectively for the development of aminoglycoside-related renal failure, defined as at least a one-third reduction in renal function. In these 62 patients, no other causes for renal failure could be identified. Five of 33 (15%) of the tobramycin-treated patients and 16 of 29 (55.2%) of the gentamicin-treated patients had renal failure. Thus, gentamicin was associated with renal failure more than three times as often as was tobramycin.
Insights
Gentamicin sulfate and tobramycin sulfate are aminoglycoside antibiotics. Gentamicin was associated with renal failure more than three times as often as tobramycin in patients receiving these drugs.
Area of Science:
- Nephrology
- Pharmacology
- Clinical Medicine
Background:
- Aminoglycoside antibiotics, including gentamicin sulfate and tobramycin sulfate, are widely used but associated with ototoxicity and nephrotoxicity.
- Nearly 3.2 million individuals in the U.S. receive these antibiotics annually.
Purpose of the Study:
- To prospectively compare the incidence of aminoglycoside-related renal failure between gentamicin sulfate and tobramycin sulfate.
Main Methods:
- A prospective study followed 62 patients with normal initial renal function treated with either gentamicin or tobramycin (2-5 mg/kg/day) for at least seven days.
- Renal failure was defined as at least a one-third reduction in renal function, with other causes excluded.
Main Results:
- Renal failure developed in 15% (5/33) of tobramycin-treated patients.
- Renal failure occurred in 55.2% (16/29) of gentamicin-treated patients.
- Gentamicin was associated with renal failure over three times more frequently than tobramycin.
Conclusions:
- Gentamicin sulfate is associated with a significantly higher risk of renal failure compared to tobramycin sulfate in patients with initially normal renal function.
- These findings highlight the differential nephrotoxic potential of commonly prescribed aminoglycosides.