Monitoring levels of nephrotoxicity of different aminoglycosides during febrile neutropenia caused by nephrotoxic chemotherapy: a single centre study.
OBJECTIVE
To investigate the possible existence of increased nephrotoxicity caused by once-daily aminoglycosides in febrile neutropenic patients who were previously treated with cisplatin-based nephrotoxic chemotherapy.


METHODS
Thirty-one patients with metastatic tumors received chemotherapy and, as a result, developed febrile neutropenia. Patients were stratified with regard to chemotherapy with cisplatin (n=15) or without cisplatin (n=16). Both groups received i.v. empiric antibiotic treatment which included combinations of once-daily aminoglycosides (amikacin vs. gentamicin) with beta-lactams.


RESULTS
Increased nephrotoxicity due to administered aminoglycosides appeared significantly more frequently (p<0.05) in patients who received cisplatin-based chemotherapy. Increased nephrotoxicity differed significantly between various aminoglycosides regimens (p<0.05), being greater in the gentamicin group.


CONCLUSIONS
These results showed that cisplatin-based chemotherapy followed by a once-daily aminoglycosides regimen caused increased renal toxicity, which was more pronounced in patients treated with gentamicin vs. those treated with amikacin.
Milovic
M
M
Department of Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia. milovicmarijana@yahoo.com
Popov
I
I
Jezdic
S
S
Stojanovic
S
S
Stankovic
V
V
Radic
S
S
D000328:Adult; D000583:Amikacin / Q000009:adverse effects; D000617:Aminoglycosides / Q000009:adverse effects* / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005334:Fever / Q000139:chemically induced; D005839:Gentamicins / Q000009:adverse effects; D019337:Hematologic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D009503:Neutropenia / Q000139:chemically induced*; D011446:Prospective Studies
D000617:Aminoglycosides; D005839:Gentamicins; D000583:Amikacin