title: Aminoglycoside prescription, therapeutic monitoring and nephrotoxicity at a university hospital in Saudi Arabia.
abstract: We studied the use of aminoglycosides at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, including prescriptions, dosage, serum levels, toxic factors and treatment outcome. Two hundred and fifty-six patients on aminoglycosides were involved in the study period November-December 1994: 24 (9.4%) patients were on amikacin and 232 (90.6%) patients were on gentamicin. The serum concentration was below the therapeutic range in 75% of the patients on amikacin and 50% on gentamicin. Serum concentrations within the therapeutic range (> 20 micrograms/ml; < 35 micrograms/ml for amikacin, and > 6 micrograms/ml and < 10 micrograms/ml for gentamicin) were achieved in 4% and 44% of patients respectively. The dosage was adjusted during therapy for 57% of the patients because of low levels, and for 43% of the patients because of toxic levels. More than 30% of the patients had their serum monitored for the first time 3 days after starting aminoglycoside therapy. Aminoglycosides were discontinued before the end of the course in 157 (62%) patients because 24% of them had developed toxic levels and 24% had not responded to the treatment. Successful outcome was achieved in 170 (66%) of the patients, however, 50% of them had inappropriate serum levels. The risk factors that are significantly associated with aminoglycoside nephrotoxicity were duration of therapy (P = 0.008), renal, liver diseases and ampicillin given concurrently with the aminoglycosides (P = < 0.05).
authors.affiliation: King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: A T
authors.initials: AT
authors.lastname: Eltahawy
authors.forename: A A
authors.initials: AA
authors.lastname: Bahnassy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000583:Amikacin / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005839:Gentamicins / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia; D013223:Statistics as Topic; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D000583:Amikacin