AMINOGLYCOSIDE NEPHROTOXICITY - COMPARATIVE-ASSESSMENT IN CRITICALLY ILL PATIENTS

  • 1 January 1979
    • journal article
    • research article
    • Vol. 10  (4) , 257-266
Abstract
In a prospective trial to determine the incidence of nephrotoxicity with each of 3 aminoglycoside antibiotics, adults in intensive care units with presumed or proven bacterial infections were treated with i.v. gentamicin, tobramycin, or amikacin. Treatment groups were similar regarding age, other medical disorders, type of infection, duration of aminoglycoside therapy, additional antibiotics used, other drugs prescribed (notably diuretics and corticosteroids) and rate of superinfection. Nephrotoxicity occurred with gentamicin during 44/121 (36.3%) treatment courses, with tobramycin during 21/92 (22.8%) courses, and with amikacin during 4/16 (25.0%) courses. Although frequent, nephrotoxicity reversed after treatment stopped. Tobramycin nephrotoxicity occurred significantly less often than did gentamicin nephrotoxicity (P < 0.05). The relative safety of tobramycin may result from lower tissue accumulation during therapy.