Outcomes in patients with gram-negative sepsis treated with gentamicin

Pillans, Peter, Iedema, Joel, Donovan, Peter, Newbery, Robert, Whitehead, Venetia, Halliday, Cameron, Sheehy, Robert, Springford, Annaka and Patterson, Tina (2012) Outcomes in patients with gram-negative sepsis treated with gentamicin. Therapeutic Advances in Drug Safety, 3 3: 109-113. doi:10.1177/2042098612439495

Author Pillans, Peter
Iedema, Joel
Donovan, Peter
Newbery, Robert
Whitehead, Venetia
Halliday, Cameron
Sheehy, Robert
Springford, Annaka
Patterson, Tina
Title Outcomes in patients with gram-negative sepsis treated with gentamicin
Journal name Therapeutic Advances in Drug Safety   Check publisher's open access policy
ISSN 2042-0986
Publication date 2012
Year available 2012
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1177/2042098612439495
Open Access Status
Volume 3
Issue 3
Start page 109
End page 113
Total pages 5
Place of publication London, United Kingdom
Publisher Sage Publications Ltd.
Collection year 2012
Language eng
Subject 2736 Pharmacology (medical)
Abstract Objective: Recent changes to therapeutic drug monitoring (TDM) of gentamicin have been advocated in Australia. It remains uncertain whether these will have an effect on hard clinical endpoints. The aim of this study was to determine clinical outcomes in patients with gram-negative infections treated with gentamicin.Methods: Microbiology results of patients with confirmed gram-negative cultures were retrospectively reviewed and those treated with gentamicin included. Medical records were reviewed and patient demographics, diagnosis, renal function, comorbidities, gentamicin doses, duration, monitoring, concomitant antibiotics, antimicrobial sensitivity and clinical and microbiological outcomes recorded.Results: A total of 100 patients were included in the study: 52% were male, median age 64 years (17-97). Total body weight was recorded in 56% (median 74.5 kg, range 35-134 kg). Most patients had two or more important comorbidities. A total of 72% received empiric and 28% directed treatment. The organism was identified on blood culture in 45%, urine culture in 43% and aspiration of liver abscess in 12%; 95% of organisms were sensitive to gentamicin. Baseline renal function was normal in 62%. Mean gentamicin dose was 3.9 ± 0.9 mg/kg and mean duration 2.9 ± 2.5 days. Only 21% had optimal TDM. Clinical outcome was favourable in 90%. There were no cases of preventable serious toxicity.Conclusions: Despite the modest doses of gentamicin used in an elderly population with comorbidities, as well as the absence of optimal TDM, outcomes were favourable without preventable serious toxicity.
Keyword Gentamicin
Therapeutic Drug Monitoring
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collection: School of Medicine Publications
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