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

• 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
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/149.2.257

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.