Peter Craig1, Ian Starks, Gordon Bancroft, Philip Roberts. 1. Department of Trauma and Orthopaedic Surgery, University Hospital of North Staffordshire, Stoke on Trent, United Kingdom. prscraig@gmail.com
Abstract
BACKGROUND: Single dose Gentamicin (240 mg) has been shown to reduce postoperative wound infection in patients with fractured neck of femur when used in a combined antibiotic regimen. However, concerns have arisen about the risk of acute kidney injury (AKI) in these patients. OBJECTIVE: To determine if the use of prophylactic Gentamicin is associated with AKI in fractured neck of femur patients. METHODS: A historical cohort study. Pre- and post-operative creatinine mmol/l of 100 successive fractured neck of femur patients admitted from September 2010 were compared to a control of 100 age, sex and procedure matched individuals operated upon before the introduction of prophylactic Gentamicin (2005). AKI was defined as an increase in serum creatinine by over 50% of base line. Statistical significance was regarded as p<0.05. RESULTS: A significant rise in creatinine levels was observed in both control (p=0.005) and study groups (p=0.001). There was neither a significant difference in peak creatinine between groups (p=0.87) nor in rates of AKI (p=0.568) between the 2 groups. CONCLUSION: Single preoperative doses of Gentamicin (240 mg) have no detrimental impact on renal function in this group. There is, however, a significant rise in creatinine following fractured neck of femur surgery, independent of Gentamicin.
BACKGROUND: Single dose Gentamicin (240 mg) has been shown to reduce postoperative wound infection in patients with fractured neck of femur when used in a combined antibiotic regimen. However, concerns have arisen about the risk of acute kidney injury (AKI) in these patients. OBJECTIVE: To determine if the use of prophylactic Gentamicin is associated with AKI in fractured neck of femur patients. METHODS: A historical cohort study. Pre- and post-operative creatinine mmol/l of 100 successive fractured neck of femur patients admitted from September 2010 were compared to a control of 100 age, sex and procedure matched individuals operated upon before the introduction of prophylactic Gentamicin (2005). AKI was defined as an increase in serum creatinine by over 50% of base line. Statistical significance was regarded as p<0.05. RESULTS: A significant rise in creatinine levels was observed in both control (p=0.005) and study groups (p=0.001). There was neither a significant difference in peak creatinine between groups (p=0.87) nor in rates of AKI (p=0.568) between the 2 groups. CONCLUSION: Single preoperative doses of Gentamicin (240 mg) have no detrimental impact on renal function in this group. There is, however, a significant rise in creatinine following fractured neck of femur surgery, independent of Gentamicin.
Authors: Rachel S Hayward; Jan Harding; Rob Molloy; Lucy Land; Kate Longcroft-Neal; David Moore; Jonathan D C Ross Journal: Br J Clin Pharmacol Date: 2017-11-03 Impact factor: 4.335