Abstract
Gentamicin was given to paediatric patients with chronic renal disease complicated by infections by Gram-negative organisms, in which renal function varied from normal to severely insufficient. Peak serum levels after an intramuscular dose of 1 mg/kg body weight ranged from 3.1 to 9.4 microgram/ml, which appeared adequate for therapy. The peak value was not related to the renal function of the individual patients. The serum half-life of gentamicin correlated inversely with the value for endogenous creatinine clearance. A diagram for the estimation of the serum half-life of gentamicin using the creatinine clearance value is presented. As a practical guide, it is recommended that the dose of gentamicin in children with renal function impairment be 1 mg/kg given intramuscularly and that the interval between doses be almost three times as long as the serum half-life, which can be estimated by means of the diagram for individual patients. The accuracy and safety of this method were confirmed by treating children with this adjusted dosage schedule.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Chan R. A., Benner E. J., Hoeprich P. D. Gentamicin therapy in renal failure: a nomogram for dosage. Ann Intern Med. 1972 May;76(5):773–778. doi: 10.7326/0003-4819-76-5-773. [DOI] [PubMed] [Google Scholar]
- Cutler R. E., Gyselynck A. M., Fleet W. P., Forrey A. W. Correlation of serum creatinine concentration and gentamicin half-life. JAMA. 1972 Feb 21;219(8):1037–1041. [PubMed] [Google Scholar]
- Gingell J. C., Waterworth P. M. Dose of gentamicin in patients with normal renal function and renal impairment. Br Med J. 1968 Apr 6;2(5596):19–22. doi: 10.1136/bmj.2.5596.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gyselynck A. M., Forrey A., Cutler R. Pharmacokinetics of gentamicin: distribution and plasma and renal clearance. J Infect Dis. 1971 Dec;124 (Suppl):S70–S76. doi: 10.1093/infdis/124.supplement_1.s70. [DOI] [PubMed] [Google Scholar]
- Kaye D., Levison M. E., Labovitz E. D. The unpredictability of serum concentrations of gentamicin: pharmacokinetics of gentamicin in patients with normal and abnormal renal function. J Infect Dis. 1974 Aug;130(2):150–154. doi: 10.1093/infdis/130.2.150. [DOI] [PubMed] [Google Scholar]
- McHenry M. C., Gavan T. L., Gifford R. W., Jr, Geurkink N. A., Van Ommen R. A., Town M. A., Wagner J. G. Gentamicin dosages for renal insufficiency. Adjustments based on endogenous creatinine clearance and serum creatinine concentration. Ann Intern Med. 1971 Feb;74(2):192–197. doi: 10.7326/0003-4819-74-2-192. [DOI] [PubMed] [Google Scholar]
