[Use of aminoglycoside antibiotics in a general hospital: kinetics consequences in those patients whose blood levels are not monitored].
A surprise monitoring of plasma aminoglycoside level was carried out in our Hospital in 55 patients. Basal samples and samples one hour after i.m. or i.v. administration were obtained. A protocol sheet with personal, clinical and therapeutic data was filled for each patient. The FPIA analysis technique (CV less than 5%) was used. Only the data related to gentamicin were evaluated, because the number of patients receiving other aminoglycosides was very low (5 cases). The most usual dose and interval were 80 mg (91%) and 12 hours (69%), respectively. The administration routes were i.v. (52%) and i.m. (48%). Blood urea and/or creatinine levels were not measured in 22% of patients. The baseline gentamicin levels were subtherapeutic in 30%, therapeutical in 57%, and toxic in 13%, and 50%, 46% and 4%, respectively, for the levels after one hour. In patients with abnormal renal function a good correlation could be demonstrated (r = 0.96; p less than 0.001) between creatinine level and gentamicin 1/2 time. This correlation was absent in patients with normal renal function. When the dose of the antibiotic was adjusted to the weight of the patient, the frequency of therapeutic levels was higher (47%; p less than 0.03); in these cases, the most common administration interval was 8 hours (p less than 0.01). We emphasize the lack of control of the renal function in 22% of patients, stressing that the lack of monitoring systematically results in potentially subtherapeutic levels in more than one half of the investigated patients (57%).
Saucedo
R
R
Ortego Centeno
N
N
Mota
M C
MC
López Ruz
M A
MA
Rodríguez López
C M
CM
López de Heredia
E
E
García Delgado
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D003404:Creatinine / Q000097:blood; D004334:Drug Administration Schedule; D005839:Gentamicins / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D006769:Hospitals, General; D006801:Humans; D007262:Infusions, Intravenous; D007273:Injections, Intramuscular; D007674:Kidney Diseases / Q000097:blood; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D013030:Spain
D005839:Gentamicins; D003404:Creatinine
Utilización de antibióticos aminoglucósidos en un hospital general: consecuencias cinéticas en aquellos pacientes en los que no se monitorizan sus niveles plasmáticos.