No increased risk of acute kidney injury after a single dose of gentamicin in patients with sepsis

Maarten Cobussen, Jaclyn M. L. de Kort, Robert M. Dennert, Selwyn H. Lowe, Patricia Stassen - Marx*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Aminoglycosides are frequently used in the empirical treatment of sepsis. However, aminoglycosides may induce acute kidney injury (AKI). Data is lacking on the renal safety of a single dose of aminoglycosides in septic patients visiting the emergency department (ED). Aim To investigate the incidence of AKI in septic patients after a single dose of gentamicin (5mg/kg) and to evaluate possible risk factors. Methods This study retrospectively followed patients, aged18 years, visiting the ED and fulfilling sepsis criteria for 1 year. Two groups were analysed: septic patients receiving gentamicin in combination with beta-lactam antibiotics and a control group with pneumosepsis patients only without gentamicin. Renal function was determined prior to admission, at presentation and during the following 2 weeks. AKI was defined according to the RIFLE criteria. Results In total, 302 patients were included, 179 in the gentamicin and 123 in the control group. Mean gentamicin dose was 4.7 +/- 0.7mg/kg. At admission, 26.8% of the gentamicin and 16.3% of the control group had AKI. After admission, AKI occurred in 6.7% of the gentamicin and in 3.3% of the control group (p=0.30). Occurrence of AKI was not associated with gentamicin administration, but with septic shock (31.2% in patients with AKI vs 9.8% without AKI after admission, p=0.02). Conclusion This study showed no increased risk of AKI after a single dose of gentamicin to patients with sepsis in the ED, suggesting that a single dose of gentamicin can, with regard to renal function, be safely administered to septic patients.
Original languageEnglish
Pages (from-to)274-280
JournalInfectious Diseases
Volume48
Issue number4
DOIs
Publication statusPublished - 2 Apr 2016

Keywords

  • Acute kidney injury
  • gentamicin
  • emergency department
  • nephrotoxicity
  • sepsis

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