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[Assessment of gentamicin dosage in patients before planned surgical operation]
1Zakładu Farmakologii Klinicznej Instytutu Kardiologii Ak. Med. w Poznaniu.
Abstract:
The study included 18 patients, whom before planned surgical operation administered preventively gentamicin in the dose 3 x 80 mg/24 h i.m. After 24 hours the venous blood was taken before administration of the next dose of the drug and the concentration of gentamicin was determined by FPIA method. The subtherapeutic level of the drug was found in 15 patients (83%), therapeutic level - in 2 patients (11%) and toxic level in 1 patient (6%). It seems, that in patients after surgical operation, in whom after the prophylactic administration the treatment of gentamicin is continued, it is necessary the monitoring of the concentration of this antibiotic.
Insights
Preventive gentamicin dosing before surgery often results in subtherapeutic levels in patients. Monitoring gentamicin concentrations is crucial when continuing this antibiotic post-operation to ensure effective treatment.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Infectious Diseases
Context:
- Surgical patients often receive prophylactic antibiotics.
- Gentamicin is a commonly used antibiotic for surgical prophylaxis.
- Optimizing antibiotic dosing is critical for patient outcomes.
Purpose:
- To evaluate gentamicin serum concentrations in patients receiving prophylactic intramuscular administration before surgery.
- To determine the incidence of subtherapeutic, therapeutic, and toxic gentamicin levels in this patient cohort.
Summary:
- A study involving 18 surgical patients found that prophylactic intramuscular gentamicin (80 mg three times daily) resulted in subtherapeutic levels in 83% (15 patients) within 24 hours.
- Only 11% (2 patients) achieved therapeutic gentamicin levels, and 6% (1 patient) had toxic levels.
- These findings highlight potential underdosing with standard prophylactic regimens.
Impact:
- Suggests a need for therapeutic drug monitoring of gentamicin in surgical patients, especially when treatment is continued post-operatively.
- Highlights the importance of individualized dosing strategies to achieve effective gentamicin concentrations.
- May inform revised guidelines for gentamicin prophylaxis in surgical settings to improve efficacy and safety.