Related Experiment Video

Updated: Oct 3, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Therapeutic drug monitoring can avoid iatrogenic alterations caused by 99mTc-methylene diphosphonate (MDP)-gentamicin

W L Chen1, M Y Perng, D Z Hwei

  • 1Department of Nuclear Medicine, Tri-Service General Hospital, Taipei, Taiwan, R.O.C.

Journal of Nuclear Biology and Medicine (Turin, Italy : 1991)
|December 1, 1994
PubMed

Insights

Serial pharmacokinetic dosing of gentamicin can prevent kidney toxicity and avoid false positives on bone scintigraphy. This method ensures accurate diagnostic imaging by preventing abnormal radiopharmaceutical uptake in the kidneys.

Area of Science:

  • Nephrology
  • Nuclear Medicine
  • Pharmacology

Background:

  • Gentamicin, an aminoglycoside antibiotic, effectively treats Gram-negative infections but poses a risk of nephrotoxicity.
  • Gentamicin-induced nephrotoxicity can cause abnormal renal uptake of 99mTc-MDP on bone scintigraphy, mimicking renal diseases.
  • Altered biodistribution may lead to misinterpretation of imaging results, masking or mimicking pathologies.

Purpose of the Study:

  • To evaluate serial pharmacokinetic dosing as a strategy to minimize gentamicin's nephrotoxicity.
  • To prevent the 'hot kidney' appearance on 99mTc-MDP bone scintigraphy caused by gentamicin therapy.
  • To ensure accurate diagnostic interpretation during gentamicin treatment.

Main Methods:

  • Conducted serial pharmacokinetic dosing of gentamicin in 22 patients.
  • Utilized therapeutic drug monitoring (TDM) for gentamicin therapy.
  • Performed 99mTc-MDP bone scintigraphy to assess renal uptake and biodistribution.

Main Results:

  • Serial pharmacokinetic dosing successfully avoided iatrogenic alterations in renal uptake.
  • The 'hot kidney' sign on bone scintigraphy was prevented in patients receiving tailored gentamicin dosing.
  • Therapeutic drug monitoring guided dosing to maintain efficacy while reducing renal side effects.

Conclusions:

  • Serial pharmacokinetic dosing is an effective method to mitigate gentamicin-induced nephrotoxicity.
  • This dosing strategy prevents misleading scintigraphic findings, improving diagnostic accuracy.
  • Optimizing gentamicin therapy through TDM and pharmacokinetic dosing enhances patient outcomes and diagnostic reliability.

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