Abstract
Objectives: The aim of this randomized study was to investigate
the effects of once versus twice daily gentamicin dosing
on renal function and measures of infectious disease in
a population with infective endocarditis (IE).
Methods: Seventy-one IE patients needing gentamicin treatment according
to guidelines were randomized to either once (n = 37) or
twice daily (n = 34) doses of gentamicin. Kidney function
(glomerular filtration rate, GFR) was measured with an isotope
method ( 51 Cr-EDTA) at the beginning of treatment and
at discharge. Treatment efficacy was assessed by C-reactive
protein (CRP) time to half-life, mean CRP and leukocytes. Results:
Baseline GFR was similar in the two groups. Both
groups displayed a significant fall in GFR from admission to
discharge. The mean decrease in GFR was as follows: with
once daily gentamicin, 17.0% (95% confidence interval 7.5–
26.5), and with twice daily gentamicin, 20.4% (95% confidence
interval 12.0–28.8). However, there was no significant
difference in the GFR decrease between the once and twice
daily regimens (p = 0.573). No difference in infection parameters
was demonstrated between the two dosing regimens.
Conclusions: A twice daily gentamicin dosing regimen is
neither less nephrotoxic nor more efficient than a once daily
regimen in the treatment of IE patients. When indicated,
gentamicin may therefore also be administered as a singledose
regimen in the treatment of IE patients.
the effects of once versus twice daily gentamicin dosing
on renal function and measures of infectious disease in
a population with infective endocarditis (IE).
Methods: Seventy-one IE patients needing gentamicin treatment according
to guidelines were randomized to either once (n = 37) or
twice daily (n = 34) doses of gentamicin. Kidney function
(glomerular filtration rate, GFR) was measured with an isotope
method ( 51 Cr-EDTA) at the beginning of treatment and
at discharge. Treatment efficacy was assessed by C-reactive
protein (CRP) time to half-life, mean CRP and leukocytes. Results:
Baseline GFR was similar in the two groups. Both
groups displayed a significant fall in GFR from admission to
discharge. The mean decrease in GFR was as follows: with
once daily gentamicin, 17.0% (95% confidence interval 7.5–
26.5), and with twice daily gentamicin, 20.4% (95% confidence
interval 12.0–28.8). However, there was no significant
difference in the GFR decrease between the once and twice
daily regimens (p = 0.573). No difference in infection parameters
was demonstrated between the two dosing regimens.
Conclusions: A twice daily gentamicin dosing regimen is
neither less nephrotoxic nor more efficient than a once daily
regimen in the treatment of IE patients. When indicated,
gentamicin may therefore also be administered as a singledose
regimen in the treatment of IE patients.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Cardiology |
| Vol/bind | 119 |
| Udgave nummer | 2 |
| Sider (fra-til) | 65-71 |
| Antal sider | 7 |
| ISSN | 0008-6312 |
| DOI | |
| Status | Udgivet - sep. 2011 |
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