NEPHROTOXICITY INDUCED BY GENTAMICIN AND AMIKACIN

  • 1 January 1978
    • journal article
    • research article
    • Vol. 142  (3) , 85-90
Abstract
Nephrotoxicity associated with gentamicin or amikacin therapy was evaluated in 124 patients. Incidence of definite nephrotoxicity was 10.5% during therapy, with a mean increase in creatinine of 1.0 mg/100 ml (range, 0.5-3.6 mg/100 ml). Nephrotoxicity developed late in therapy (mean, day 10), and creatinine continued to increase after cessation of therapy for as long as 9 days. Age, initial creatinine, total dose and initial peak and valley levels did not correlate with nephrotoxicity. Nephrotoxicity developed in 8 of 97 patients treated for .ltoreq. 11 days and 5 of 19 treated for > 11 days (chi square, P < .01). Peak and valley levels rose significantly (t-test, P < .05) during therapy and increased more in those with nephrotoxicity. A peak level of amikacin of .gtoreq. 38.5 .mu.g/ml or of gentamicin of .gtoreq. 10 .mu.g/ml or a rise in valley levels of amikacin above 10 .mu.g/ml was associated with nephrotoxicity (chi square, P < .025). These data help define the natural history and host and drug factors that affect development of gentamicin- and amikacin-induced nephrotoxicity.

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