Renal and Auditory Toxicity of High-Dose, Prolonged Therapy with Gentamicin and Tobramycin in Pseudomonas Endocarditis

The nephrotoxicity and auditory toxicity of high-dose (mean, 28.6 g) and prolonged (mean, 61.6 days) courses of gentamicin and tobramycin were monitored in 15 patients receiving 17 courses of treatment for pseudomonas endocarditis. Doses were adjusted in a manner that maintained peak levels of amino...

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Bibliographic Details
Published in:The Journal of infectious diseases 1984-02, Vol.149 (2), p.257-263
Main Authors: Tablan, Ofelia C., Reyes, Milagros P., Rintelmann, William F., Lerner, A. Martin
Format: Article
Language:English
Subjects:
Administered dose
Adult
Aminoglycosides
Antibiotics
Auditory perception
Auditory Threshold
Biological and medical sciences
Creatinine - blood
Dosage
Drug toxicity and drugs side effects treatment
Endocarditis
Endocarditis, Bacterial - drug therapy
Female
Gentamicins - administration & dosage
Gentamicins - adverse effects
Hearing loss
Hearing Loss - chemically induced
Hearing Loss, Bilateral - chemically induced
Humans
Infections
Kidney Diseases - blood
Kidney Diseases - chemically induced
Male
Medical sciences
Nephrotoxicity
Pharmacology. Drug treatments
Pseudomonas
Pseudomonas aeruginosa
Pseudomonas Infections - drug therapy
Tobramycin - administration & dosage
Tobramycin - adverse effects
Toxicity: urogenital system
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Summary:The nephrotoxicity and auditory toxicity of high-dose (mean, 28.6 g) and prolonged (mean, 61.6 days) courses of gentamicin and tobramycin were monitored in 15 patients receiving 17 courses of treatment for pseudomonas endocarditis. Doses were adjusted in a manner that maintained peak levels of aminoglycoside in serum at 12–15 µg/ml and trough levels at < 2 µg/ml. Drug-related renal dysfunction and auditory toxicity occurred in 63% and 44%, respectively, of gentamicin-treated patients and in 43% and 25%, respectively, of tobramycin-treated patients. Mean maximal rises (± SEM).in serum creatinine levels were 0.8 (± 0.4) mg/dl in the group given gentamicin and 1.6 (± 0.7) mg/dl in the group given tobramycin. Mean maximal decreases in pure-tone hearing threshold levels were greater in gentamicin-treated patients (58.3 dB) than in those given tobramycin (22.5 dB). Both forms of toxicity appeared earlier and at a smaller dose with gentamicin than with tobramycin.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/149.2.257