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学科主题: 临床医学
题名:
THE ROLE OF MONITORING GENTAMICIN LEVELS IN PATIENTS WITH GRAM-NEGATIVE PERITONEAL DIALYSIS-ASSOCIATED PERITONITIS
作者: Tang, Wen1,2; Cho, Yeoungjee2; Hawley, Carmel M.2; Badve, Sunil V.2; Johnson, David W.2
关键词: Aminoglycosides ; gentamicin ; peritoneal dialysis ; peritonitis ; therapeutic drug monitoring ; kidney failure ; chronic outcomes
刊名: PERITONEAL DIALYSIS INTERNATIONAL
发表日期: 2014-03-01
DOI: 10.3747/pdi.2012.00318
卷: 34, 期:2, 页:219-226
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: RESIDUAL RENAL-FUNCTION ; MULTICENTER REGISTRY ; INFECTIONS RECOMMENDATIONS ; ANTIBIOTIC LEVELS ; NEW-ZEALAND ; OUTCOMES ; PHARMACOKINETICS ; AUSTRALIA ; AMINOGLYCOSIDES ; MICROBIOLOGY
英文摘要:

Background: There is limited available evidence regarding the role of monitoring serum gentamicin concentrations in peritoneal dialysis (PD) patients receiving this antimicrobial agent in gram-negative PD-associated peritonitis.

Methods: Using data collected in all patients receiving PD at a single center who experienced a gram-negative peritonitis episode between 1 January 2005 and 31 December 2011, we investigated the relationship between measured serum gentamicin levels on day 2 following initial empiric antibiotic therapy and subsequent clinical outcomes of confirmed gram-negative peritonitis.

Results: Serum gentamicin levels were performed on day 2 in 51 (77%) of 66 first gram-negative peritonitis episodes. Average serum gentamicin levels on day 2 were 1.83 +/- 0.84 mg/L with levels exceeding 2 mg/L in 22 (43%) cases. The overall cure rate was 64%. No cases of ototoxicity were observed. Day-2 gentamicin levels were not significantly different between patients who did and did not have a complication or cure. Using multivariable logistic regression analysis, failure to cure peritonitis was not associated with either day-2 gentamicin level (adjusted odds ratio (OR) 0.96, 95% confidence interval (CI) 0.25 - 3.73) or continuation of gentamicin therapy beyond day 2 (OR 0.28, 0.02 - 3.56). The only exception was polymicrobial peritonitis, where day-2 gentamicin levels were significantly higher in episodes that were cured (2.06 +/- 0.41 vs 1.29 +/- 0.71, p = 0.01). In 17 (26%) patients receiving extended gentamicin therapy, day-5 gentamicin levels were not significantly related to peritonitis cure.

Conclusion: Day-2 gentamicin levels did not predict gentamicin-related harm or efficacy during short-course gentamicin therapy for gram-negative PD-related peritonitis, except in cases of polymicrobial peritonitis, where higher levels were associated with cure.

语种: 英语
所属项目编号: 30900681 ; D09050704310905 ; 76496-02
项目资助者: International Society of Peritoneal Dialysis Scholarship ; National Natural Science Foundation of China ; Beijing Municipal Science &amp ; Technology Commission ; Peking University Third Hospital ; Queensland Government Health Research Fellowship
WOS记录号: WOS:000336083400012
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/61491
Appears in Collections:北京大学第三临床医学院_肾内科_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Div Nephrol, Beijing 100871, Peoples R China
2.Univ Queensland, Princess Alexandra Hosp, Dept Nephrol, Brisbane, Qld, Australia

Recommended Citation:
Tang, Wen,Cho, Yeoungjee,Hawley, Carmel M.,et al. THE ROLE OF MONITORING GENTAMICIN LEVELS IN PATIENTS WITH GRAM-NEGATIVE PERITONEAL DIALYSIS-ASSOCIATED PERITONITIS[J]. PERITONEAL DIALYSIS INTERNATIONAL,2014,34(2):219-226.
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