Therapy with Gentamicin for Bacteremic Infections: Results with 53 Patients

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Abstract
Fifty-three patients with bacteremia due to gram-negative bacilli were treated with gentamicin alone (31 patients), or with gentamicin combined with another antibiotic (22 patients). Gentamicin was administered parenterally in total daily doses of 3–6 mg/kg of body weight. Dosage was adjusted after the first full day for 14 patients with impaired renal function caused by preexisting renal disease. Treatment was successful in 36 patients. Adverse reactions (transient azotemia) occurred in four patients. Therapeutic failure could be attributed to one or more of these conditions: fatal underlying noninfectious disease, overwhelming shock, profound granulocytopenia, septic intravascular lesions, intravenous or intracardiac foreign body, hepatobiliary infection, undrained abscess, gentamicin-resistant pathogens, and superinfection. Gentamicin appears to be effective for treating gram-negative bacteremia when organisms are susceptible, a large dosage is employed, sources of infection are accessible to the drug and lesions are amenable to therapy, and when there is no underlying lethal disease.

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