Risk factors for toxicity in elderly patients given aminoglycosides once daily.
OBJECTIVE
To determine the risk factors for aminoglycoside toxicity in the elderly.


METHODS
Prospective observational study.


METHODS
Acute care teaching hospital serving predominantly veterans.


METHODS
Consecutive patients aged 70 years and over receiving aminoglycosides.


METHODS
None.


RESULTS
Thirteen (15%) of 88 patients developed aminoglycoside-related nephrotoxicity and 3 (3.4%) developed otovestibular toxicity. Multivariate analysis showed that increasing duration of aminoglycoside therapy was the only factor significantly associated with development of toxicity. Elevated baseline serum creatinine level (p = .02) and use of allopurinol (p = .03) were risk factors specifically for nephrotoxicity. Only 2 (3.9%) of 51 patients receiving aminoglycosides 7 or fewer days developed nephrotoxicity, as compared with 11 (30%) of 37 receiving the drugs for 8 to 14 days and 4 (50%) of 8 treated for more than 14 days.


CONCLUSIONS
Although toxicity is common in elderly patients treated with aminoglycosides, limiting the duration of aminoglycoside therapy to less than a week can substantially reduce risk of toxicity.
Paterson
D L
DL
Infectious Disease Section, Veterans Affair Medical Center, Pittsburgh, PA 15240, USA.
Robson
J M
JM
Wagener
M M
MM
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D005260:Female; D005839:Gentamicins / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D006311:Hearing Disorders / Q000139:chemically induced; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced*; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D014031:Tobramycin / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D003404:Creatinine; D014031:Tobramycin