Adequacy of a hospital-wide standard dose of 7mg/kg bodyweight gentamicin sufficient to achieve an adequate prophylactic maximum serum concentration (Cmax) in burn patients undergoing surgical burn wound treatment.
BACKGROUND
Pharmacokinetics of drugs can be significantly altered in burn patients. The aim of our study was to validate if the current hospital-wide standard dosage of 7mg/kg total bodyweight gentamicin is sufficient to achieve an adequate prophylactic Cmax(Cmax≥20mg/L).


METHODS
A prospective observational cohort pharmacokinetic study was conducted in burn patients undergoing surgical burn wound treatment.


RESULTS
36/40 (90%) burn patients undergoing surgical burn wound treatment at Rotterdam Burn Centre (Maasstad Hospital), the Netherlands, achieved adequate prophylactic serum concentrations (Cmax≥20mg/L) after a single prophylactic intravenous dose of 7mg/kg total bodyweight gentamicin. Total Body Surface Area (TBSA) burned and total bodyweight were statistically significantly correlated with the Cmax, with correlation coefficients of -0.316, 0.443 and p values of 0.047, 0.004, respectively. Other covariates (age, time after injury, serum creatinine, dose, gender, intensive care admittance) were not statistically significantly correlated. Occurrence of postoperative infection was limited (n=1), no statistically significant difference was observed between patients with a therapeutic and patients with a subtherapeutic serum concentration.


CONCLUSIONS
The current hospital-wide standard dosage of 7mg/kg total bodyweight is sufficient to achieve an adequate prophylactic Cmaxin burn patients undergoing surgical burn wound treatment.
Department of Hospital Pharmacy, Maasstad Hospital, Maasstadweg 21, 3079DZ Rotterdam, the Netherlands. Electronic address: BorraL@maasstadziekenhuis.nl.
Lennaert C P
LC
Borra
Department of Hospital Pharmacy, Maasstad Hospital, Maasstadweg 21, 3079DZ Rotterdam, the Netherlands. Electronic address: BoschT@maasstadziekenhuis.nl.
Tessa M
TM
Bosch
Association of Dutch Burn centres. Burn Centre, Maasstad Hospital, Maasstadweg 21, 3079DZ Rotterdam, the Netherlands. Electronic address: BaarM@maasstadziekenhuis.nl.
Margriet E
ME
van Baar
Burn Centre, Maasstad Hospital, Maasstadweg 21, 3079DZ Rotterdam, the Netherlands. Electronic address: DokterJ@maasstadziekenhuis.nl.
Jan
J
Dokter
Burn Centre, Maasstad Hospital, Maasstadweg 21, 3079DZ Rotterdam, the Netherlands. Electronic address: OenI@maasstadziekenhuis.nl.
Irma M
IM
Oen
Department of Hospital Pharmacy, Maasstad Hospital, Maasstadweg 21, 3079DZ Rotterdam, the Netherlands. Electronic address: RuijgrokL@maasstadziekenhuis.nl.
Elisabeth J
EJ
Ruijgrok
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D019072:Antibiotic Prophylaxis / Q000379:methods*; D001830:Body Surface Area; D001835:Body Weight; D002056:Burns / Q000378:metabolism / Q000601:surgery*; D015331:Cohort Studies; D054796:Drug Dosage Calculations; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D005839:Gentamicins
Burn; Gentamicin; Infection; Pharmacokinetics