Chemoprophylactic and bactericidal efficacy of 80 mg gentamicin in a single and once-daily dosing.
OBJECTIVE
The objective was to examine the biodistribution, the chemoprophylactic, and the bactericide efficacy of 80-mg gentamicin single or once-daily dosing.


METHODS
Ninety-six patients who had had cesarean section or gynecological surgery received 80 mg gentamicin for chemoprophylaxis. A second group of 92 patients with Gram-negative infection received once-daily 80-mg gentamicin intramuscularly, combined with cefoxitin or ceforanide, for 5 days. Gentamicin serum and tissue concentration was determined 1 h after the first administration.


RESULTS
The chemoprophylactic efficacy of gentamicin was 93.7%. The treatment efficacy was high in patients with chorioamnionitis and endometritis (92.9%), moderate in those with wound infection (69.5%), and less effective in those with septicemia (55.6%). Twenty-six percent of patients continued with antibiotics for infection control. The mean serum level was 4.48+/-0.49 and 5.56+/-0.66 microg/ml in obstetrical and gynecological patients respectively (p>0.05). Serum levels >4 microg/ml were achieved in 91% of patients.


CONCLUSIONS
A single dose of 80 mg gentamicin offers chemoprophylaxis and achieves therapeutic serum-concentrations 1 h after administration. The 5-day combination of once-daily 80 mg gentamicin with a second-generation cephalosporin is effective in patients with chorioamnionitis and endometritis, but only moderately effective in those with wound infections and septicemia.
Sifakis
Stavros
S
Department of Obstetrics and Gynecology, University of Crete, 228 Oulaf Palme Street, 71410 Heraklion, Crete, Greece. sifakis@excite.com
Angelakis
Emmanuel
E
Makrigiannakis
Antonis
A
Orfanoudaki
Irene
I
Christakis-Hampsas
Maria
M
Katonis
Pavlos
P
Tsatsakis
Aristidis
A
Koumantakis
Eugenios
E
D000328:Adult; D000653:Amniotic Fluid / Q000378:metabolism; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002511:Cephalosporins / Q000008:administration & dosage / Q000494:pharmacology; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000188:drug therapy; D004716:Endometritis / Q000188:drug therapy; D004717:Endometrium / Q000187:drug effects; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005839:Gentamicins / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy; D006801:Humans; D006924:Hymen / Q000378:metabolism; D010920:Placenta / Q000378:metabolism; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D014018:Tissue Distribution; D016896:Treatment Outcome; D014470:Umbilical Cord / Q000378:metabolism
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005839:Gentamicins