AUDIT OF ONCE‐DAILY DOSING GENTAMICIN THERAPY IN NEUTROPENIC FEVER

Author:

Cooke RPD1,Grace RJ2,Gover PA2

Affiliation:

1. Departments of Medical Microbiology District General Hospital Eastbourne East Sussex

2. Departments of Haematology District General Hospital Eastbourne East Sussex

Abstract

SUMMARYDuring a 12‐month study, 42 adult patients with febrile neutropenia (granulocytes <1 × 109/l) were treated with once‐daily gentamicin (5 mg/kg). Serum gentamicin trough levels were measured 24 hours after the first dose, then twice weekly if <1 mg/l. Gentamicin was halved if the trough level was 1‐2 mg/l and usually stopped if >2 mg/l. One hundred and sixty samples were assayed: 122 (76%) <1 mg/l, 27 (17%) I‐2 mg/l and 11 (7%) >2 mg/l. All 1‐2 mg/l samples and three of the >2 mg/l samples (taken at the wrong time) reverted to <1 mg/l with dosage adjustment. The protocol proved simple and effective with a low incidence of gentamicin‐associated nephrotoxicity (7%) and no sepsis‐related deaths.

Publisher

Wiley

Subject

General Medicine

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