OBJECTIVE: To determine whether there was an increased incidence of nephrotoxicity in elderly patients (> or =65 y) prescribed single-dose (SD) versus multiple-dose (MD) aminoglycosides and whether aminoglycoside-induced nephrotoxicity was associated with length of therapy and other risk factors. METHODS: A prospective, observational audit at a university teaching hospital was conducted. Physician prescribing was used to stratify subjects according to dosing regimen: MD (n = 60) or SD (n = 26). Nephrotoxicity was defined as an increase in the serum creatinine level of 0.5 mg/dL sustained over 2 days. RESULTS: Eighty-six patients were included; 9.3% developed nephrotoxicity, of whom 62.5% received SD therapy. The incidence of nephrotoxicity did not differ between regimens (p = 0.051). There was an increased length of therapy in those who developed nephrotoxicity (mean +/- SD 6.1 +/- 6.2 vs. 3.7 +/- 2.8 d; p = 0.044). Additionally, patients who developed nephrotoxicity had an increased length of hospitalization (20.3 +/- 16.1 vs. 8.4 +/- 5.4 d; p < 0.001). Nephrotoxicity correlated with a diagnosis of diabetes mellitus (OR 15.1; 95% CI 1.11 to 205), concomitant angiotensin-converting enzyme (ACE) inhibitor therapy (OR 28.0; 95% CI 2.15 to 365), and SD therapy (OR 20.7; 95% CI 1.45 to 297). CONCLUSIONS: Our overall incidence of nephrotoxicity is consistent with that reported in the literature. A diagnosis of diabetes mellitus, concomitant use of ACE inhibitors, and SD regimens were risk factors for the development of nephrotoxicity. An adequately powered, randomized trial is needed to assess whether a difference in the incidence of nephrotoxicity exists between SD and MD therapy in the elderly.
OBJECTIVE: To determine whether there was an increased incidence of nephrotoxicity in elderly patients (> or =65 y) prescribed single-dose (SD) versus multiple-dose (MD) aminoglycosides and whether aminoglycoside-induced nephrotoxicity was associated with length of therapy and other risk factors. METHODS: A prospective, observational audit at a university teaching hospital was conducted. Physician prescribing was used to stratify subjects according to dosing regimen: MD (n = 60) or SD (n = 26). Nephrotoxicity was defined as an increase in the serum creatinine level of 0.5 mg/dL sustained over 2 days. RESULTS: Eighty-six patients were included; 9.3% developed nephrotoxicity, of whom 62.5% received SD therapy. The incidence of nephrotoxicity did not differ between regimens (p = 0.051). There was an increased length of therapy in those who developed nephrotoxicity (mean +/- SD 6.1 +/- 6.2 vs. 3.7 +/- 2.8 d; p = 0.044). Additionally, patients who developed nephrotoxicity had an increased length of hospitalization (20.3 +/- 16.1 vs. 8.4 +/- 5.4 d; p < 0.001). Nephrotoxicity correlated with a diagnosis of diabetes mellitus (OR 15.1; 95% CI 1.11 to 205), concomitant angiotensin-converting enzyme (ACE) inhibitor therapy (OR 28.0; 95% CI 2.15 to 365), and SD therapy (OR 20.7; 95% CI 1.45 to 297). CONCLUSIONS: Our overall incidence of nephrotoxicity is consistent with that reported in the literature. A diagnosis of diabetes mellitus, concomitant use of ACE inhibitors, and SD regimens were risk factors for the development of nephrotoxicity. An adequately powered, randomized trial is needed to assess whether a difference in the incidence of nephrotoxicity exists between SD and MD therapy in the elderly.
Authors: D Ozturk-Engin; H Erdem; S Gencer; S Kaya; A I Baran; A Batirel; R Tekin; M K Celen; A Denk; S Guler; M Ulug; H Turan; A U Pekok; G Mermut; S Kaya; M Tasbakan; N Tulek; Y Cag; A Inan; A Yalci; C Ataman-Hatipoglu; I Gonen; A Dogan-Celik; F Bozkurt; S Gulsun; M Sunnetcioglu; T Guven; F Duygu; E Parlak; H Sozen; S Tosun; T Demirdal; E Guclu; O Karabay; N Uzun; O Gunal; H Diktas; A Haykir-Solay; A Erbay; C Kader; O Aydin; A Erdem; N Elaldi; A Kadanali; Z Yulugkural; L Gorenek; M Altındis; S Bolukcu; C Agalar; N Ormeci Journal: Eur J Clin Microbiol Infect Dis Date: 2014-02-21 Impact factor: 3.267
Authors: João F P Oliveira; Carolina A Silva; Camila D Barbieri; Giselle M Oliveira; Dirce M T Zanetta; Emmanuel A Burdmann Journal: Antimicrob Agents Chemother Date: 2009-04-13 Impact factor: 5.191
Authors: Sarah Carlsen; Jonas Boel; Jens Otto Jarløv; Ida Gjørup; Christian Søborg; Magnus Arpi Journal: Eur J Clin Microbiol Infect Dis Date: 2018-09-17 Impact factor: 3.267