Audit of once-daily dosing gentamicin therapy in neutropenic fever.
During a 12-month study, 42 adult patients with febrile neutropenia (granulocytes < 1 x 10(9)/l) were treated with once-daily gentamicin (5 mg/kg). Serum gentamicin trough levels were measured 24 hours after the first dose, then twice weekly if < 1 mg/l. Gentamicin was halved if the trough level was 1-2 mg/l and usually stopped if > 2 mg/l. One hundred and sixty samples were assayed: 122 (76%) < 1 mg/l, 27 (17%) l-2 mg/l and 11 (7%) > 2 mg/l. All 1-2 mg/l samples and three of the > 2 mg/l samples (taken at the wrong time) reverted to <1 mg/l with dosage adjustment. The protocol proved simple and effective with a low incidence of gentamicin-associated nephrotoxicity (7%) and no sepsis-related deaths.
Cooke
R P
RP
Department of Medical Microbiology, District General Hospital, Eastbourne, East Sussex.
Grace
R J
RJ
Gover
P A
PA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000097:blood; D001855:Bone Marrow Diseases / Q000150:complications; D004334:Drug Administration Schedule; D005334:Fever / Q000150:complications / Q000188:drug therapy*; D005839:Gentamicins / Q000008:administration & dosage* / Q000097:blood; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D005839:Gentamicins