title: Use of Gentamicin as Empiric Coverage for Ventilator-Associated Pneumonia: The "Con" Perspective.
abstract: BACKGROUND
  Gentamicin is used commonly as an empiric antibiotic prior to culture evidence in the treatment of ventilator-associated pneumonia (VAP) in surgical patients.
  
  
  METHODS
  The published literature on the use of gentamicin for empiric therapy in VAP was reviewed and in combination with the author's personal experience, an evaluation has been made about the indications for the use of this antibiotic in VAP.
  
  
  RESULTS
  Empiric gentamicin use appears to benefit less than 1% of patients in the treatment of presumptive VAP. The problematic pharmacokinetics of gentamicin use in this patient population combined with potential toxicity from the drug can be observed to yield greater risks than benefits in this clinical situation when published evidence is reviewed.
  
  
  CONCLUSIONS
  There is no definitive evidence to support empiric use of gentamicin in the treatment of VAP when evaluated on a cost-effective basis.
authors.affiliation: 1 Mercy Northwest Arkansas Hospital , Rogers, Arkansas.
authors.forename: Matthew
authors.initials: M
authors.lastname: Byrnes
authors.affiliation: 2 St. Catherine's Hospital , Garden City, Kansas.
authors.forename: Rob
authors.initials: R
authors.lastname: Dorman
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005839:Gentamicins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D053717:Pneumonia, Ventilator-Associated / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins