RENAL TOXICITY DURING THERAPY WITH GENTAMICIN OR TOBRAMYCIN

  • 1 January 1981
    • journal article
    • research article
    • Vol. 56  (9) , 556-559
Abstract
Patients (27) who had normal pretherapy renal clearance by the [125I]iothalamate test were randomly assigned gentamicin or tobramycin for therapy of infections due to susceptible bacteria. No patients were critically ill or had evidence of bacteremia. Mean age and duration of therapy were 51 yr and 14 days, respectively, for 15 patients treated with gentamicin, and 45 yr and 13 days for 12 patients treated with tobramycin. At the completion of therapy, 6 (40%) gentamicin and 7 (58%) tobramycin patients had a decrease in renal clearance of at least 14% below baseline. The mean decrease was 26% in the gentamicin group and 23% in the tobramycin group. Simultaneous increases in serum creatinine concentrations (.gtoreq. 0.2 mg/dl) occurred in 4 (31%) of 13 patients. Of 4 patients who had renal clearance, studies repeated 3 wk-6 mo. after therapy, 2 had stable function but at 16-19% below baseline. Mean urinary concentration of N-acetyl glucosaminidase and alanine aminopeptidase increased faster and to higher levels with gentamicin. On an individual patient basis, they were not predictive of a decrease in renal clearance in either therapy group.

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