Is prophylactic Gentamicin associated with acute kidney injury in patients undergoing surgery for fractured neck of femur?
BACKGROUND
Single dose Gentamicin (240 mg) has been shown to reduce postoperative wound infection in patients with fractured neck of femur when used in a combined antibiotic regimen. However, concerns have arisen about the risk of acute kidney injury (AKI) in these patients.


OBJECTIVE
To determine if the use of prophylactic Gentamicin is associated with AKI in fractured neck of femur patients.


METHODS
A historical cohort study. Pre- and post-operative creatinine mmol/l of 100 successive fractured neck of femur patients admitted from September 2010 were compared to a control of 100 age, sex and procedure matched individuals operated upon before the introduction of prophylactic Gentamicin (2005). AKI was defined as an increase in serum creatinine by over 50% of base line. Statistical significance was regarded as p<0.05.


RESULTS
A significant rise in creatinine levels was observed in both control (p=0.005) and study groups (p=0.001). There was neither a significant difference in peak creatinine between groups (p=0.87) nor in rates of AKI (p=0.568) between the 2 groups.


CONCLUSIONS
Single preoperative doses of Gentamicin (240 mg) have no detrimental impact on renal function in this group. There is, however, a significant rise in creatinine following fractured neck of femur surgery, independent of Gentamicin.
Department of Trauma and Orthopaedic Surgery, University Hospital of North Staffordshire, Stoke on Trent, United Kingdom. prscraig@gmail.com
Peter
P
Craig
Ian
I
Starks
Gordon
G
Bancroft
Philip
P
Roberts
D058186:Acute Kidney Injury / Q000097:blood / Q000139:chemically induced* / Q000401:mortality; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016360:Clostridioides difficile / Q000472:pathogenicity*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D005265:Femoral Neck Fractures / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D005839:Gentamicins / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity*; D011184:Postoperative Period; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000097:blood / Q000188:drug therapy* / Q000401:mortality
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D003404:Creatinine