PDF(Pubmed)
Abstract：
BACKGROUND: Gentamicin is a commonly used antibiotic with synergistic effects that is administered once or multiple times daily. However, the influence of the daily administration frequency on renal function has not yet been identified. This study aimed to investigate the effect of the daily dosing frequency on worsening renal function in patients receiving gentamicin.
METHODS: This study included 35 patients undergoing gentamicin treatment who had at least one serum trough level measured and underwent therapeutic drug monitoring (TDM). We evaluated the influence of daily dosing frequency on gentamicin trough concentration and the risk of acute kidney injury (AKI).
RESULTS: Compared to patients who received gentamicin once-daily dosing (n = 22), patients who received multiple-daily dosing (n = 13) had significantly higher initial and minimum trough concentrations after TDM. The proportion of patients with trough concentrations lower than 1.0 µg/mL was significantly higher in the once-daily dosing group at the initial trough concentration, whereas there was no significant difference at the minimum trough concentration after TDM. AKI developed in nine patients; however, there was no significant difference in the incidence of AKI according to the frequency of daily gentamicin dosing. In contrast, a higher minimum trough concentration after TDM was found to be a risk factor for AKI development with an odds ratio of 9.2 (95% confidence intervals; 1.3-65.5).
CONCLUSIONS: A higher trough concentration of gentamicin correlated with a higher incidence of AKI. The risk of developing AKI may be reduced by choosing a once-daily dosing regimen or implementing TDM.
METHODS: This study included 35 patients undergoing gentamicin treatment who had at least one serum trough level measured and underwent therapeutic drug monitoring (TDM). We evaluated the influence of daily dosing frequency on gentamicin trough concentration and the risk of acute kidney injury (AKI).
RESULTS: Compared to patients who received gentamicin once-daily dosing (n = 22), patients who received multiple-daily dosing (n = 13) had significantly higher initial and minimum trough concentrations after TDM. The proportion of patients with trough concentrations lower than 1.0 µg/mL was significantly higher in the once-daily dosing group at the initial trough concentration, whereas there was no significant difference at the minimum trough concentration after TDM. AKI developed in nine patients; however, there was no significant difference in the incidence of AKI according to the frequency of daily gentamicin dosing. In contrast, a higher minimum trough concentration after TDM was found to be a risk factor for AKI development with an odds ratio of 9.2 (95% confidence intervals; 1.3-65.5).
CONCLUSIONS: A higher trough concentration of gentamicin correlated with a higher incidence of AKI. The risk of developing AKI may be reduced by choosing a once-daily dosing regimen or implementing TDM.
摘要：
背景：庆大霉素是一种常用的具有协同作用的抗生素，每天给药一次或多次。然而,每日给药频率对肾功能的影响尚未确定.本研究旨在探讨每日给药频率对庆大霉素患者肾功能恶化的影响。
方法：本研究包括35名接受庆大霉素治疗的患者，这些患者至少测量了一个血清波谷水平并接受了治疗药物监测（TDM）。我们评估了每日给药频率对庆大霉素谷浓度和急性肾损伤（AKI）风险的影响。
结果：与接受庆大霉素每日一次给药的患者（n=22）相比，接受每日多次给药的患者(n=13)在TDM后的初始和最低谷浓度显著较高.在初始谷浓度下，每日一次给药组中，谷浓度低于1.0µg/mL的患者比例明显更高，而TDM后的最低谷浓度没有显着差异。9名患者出现AKI；然而，根据庆大霉素每日给药频率,AKI的发生率无显著差异.相比之下,发现TDM后较高的最低谷浓度是AKI发生的危险因素,比值比为9.2(95%置信区间;1.3~65.5).
结论：较高的庆大霉素谷浓度与较高的AKI发生率相关。可以通过选择每日一次给药方案或实施TDM来降低发生AKI的风险。
方法：本研究包括35名接受庆大霉素治疗的患者，这些患者至少测量了一个血清波谷水平并接受了治疗药物监测（TDM）。我们评估了每日给药频率对庆大霉素谷浓度和急性肾损伤（AKI）风险的影响。
结果：与接受庆大霉素每日一次给药的患者（n=22）相比，接受每日多次给药的患者(n=13)在TDM后的初始和最低谷浓度显著较高.在初始谷浓度下，每日一次给药组中，谷浓度低于1.0µg/mL的患者比例明显更高，而TDM后的最低谷浓度没有显着差异。9名患者出现AKI；然而，根据庆大霉素每日给药频率,AKI的发生率无显著差异.相比之下,发现TDM后较高的最低谷浓度是AKI发生的危险因素,比值比为9.2(95%置信区间;1.3~65.5).
结论：较高的庆大霉素谷浓度与较高的AKI发生率相关。可以通过选择每日一次给药方案或实施TDM来降低发生AKI的风险。
