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. 1982 Sep;22(3):376–379. doi: 10.1128/aac.22.3.376

Inactivation of amikacin and gentamicin by carbenicillin in patients with end-stage renal failure.

D C Blair, D O Duggan, E T Schroeder
PMCID: PMC183751  PMID: 7137981

Abstract

Aminoglycosides are inactivated by carbenicillin in vitro and in patients with end-stage renal failure. In vitro, amikacin is inactivated to a lesser extent than is gentamicin. In five patients on chronic hemodialysis, serum levels of amikacin alone and after repeated intravenous carbenicillin infusions were determined. Analogous gentamicin studies were conducted with five different patients. Neither amikacin serum levels nor serum clearances were affected by carbenicillin. The mean gentamicin serum half-life was significantly lower in the presence of carbenicillin: 18.4 +/- 8.2 compared with 61.6 +/- 30.7 h. Serum clearance increased significantly. The inactivation of gentamicin by carbenicillin was both time related (greater than 12 h of exposure) and concentration dependent (molar carbenicillin/gentamicin ratios greater than or equal to 39:1). Amikacin would be preferable to gentamicin in patients with end-stage renal failure.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andriole V. T. Antibiotic synergy in experimental infection with Pseudomonas. II. The effect of carbenicillin, cephalothin, or cephanone combined with tobramycin or gentamicin. J Infect Dis. 1974 Feb;129(2):124–133. doi: 10.1093/infdis/129.2.124. [DOI] [PubMed] [Google Scholar]
  2. Christopher T. G., Korn D., Blair A. D., Forrey A. W., O'Neill M. A., Cutler R. E. Gentamicin pharmacokinetics during hemodialysis. Kidney Int. 1974 Jul;6(1):38–44. doi: 10.1038/ki.1974.75. [DOI] [PubMed] [Google Scholar]
  3. Davies M., Morgan J. R., Anand C. Interactions of carbenicillin and ticarcillin with gentamicin. Antimicrob Agents Chemother. 1975 Apr;7(4):431–434. doi: 10.1128/aac.7.4.431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Ervin F. R., Bullock W. E., Jr, Nuttall C. E. Inactivation of gentamicin by penicillins in patients with renal failure. Antimicrob Agents Chemother. 1976 Jun;9(6):1004–1011. doi: 10.1128/aac.9.6.1004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Holt H. A., Broughall J. M., McCarthy M., Reeves D. S. Interactions between aminoglycoside antibiotics and carbenicillin or ticarillin. Infection. 1976;4(2):107–109. doi: 10.1007/BF01638726. [DOI] [PubMed] [Google Scholar]
  6. McLaughlin J. E., Reeves D. S. Clinical and laboratory evidence for inactivation of gentamicin by carbenicillin. Lancet. 1971 Feb 6;1(7693):261–264. doi: 10.1016/s0140-6736(71)91001-4. [DOI] [PubMed] [Google Scholar]
  7. Noone P., Pattison J. R. Therapeutic implications of interaction of gentamicin and penicillins. Lancet. 1971 Sep 11;2(7724):575–578. doi: 10.1016/s0140-6736(71)92152-0. [DOI] [PubMed] [Google Scholar]
  8. Nunning B. C., Granatek A. P., Ricci R. A. Physical compatibility and chemical stability of amikacin sulfate in combination with antibiotics in large-volume parenteral solutions - part III. Curr Ther Res Clin Exp. 1976 Oct;20(4):369–416. [PubMed] [Google Scholar]
  9. Pickering L. K., Gearhart P. Effect of time and concentration upon interaction between gentamicin, tobramycin, Netilmicin, or amikacin and carbenicillin or ticarcillin. Antimicrob Agents Chemother. 1979 Apr;15(4):592–596. doi: 10.1128/aac.15.4.592. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Riff L. J., Jackson G. G. Laboratory and clinical conditions for gentamicin inactivation by carbenicillin. Arch Intern Med. 1972 Dec;130(6):887–891. [PubMed] [Google Scholar]
  11. Sarubbi F. A., Jr, Hull J. H. Amikacin serum concentrations: prediction of levels and dosage guidelines. Ann Intern Med. 1978 Nov;89(5 Pt 1):612–618. doi: 10.7326/0003-4819-89-5-612. [DOI] [PubMed] [Google Scholar]
  12. Sedman A. J., Wagner J. G. CSTRIP, a fortran IV computer program for obtaining initial polyexponential parameter estimates. J Pharm Sci. 1976 Jul;65(7):1006–1010. doi: 10.1002/jps.2600650713. [DOI] [PubMed] [Google Scholar]
  13. Smith C. B., Wilfert J. N., Dans P. E., Kurrus T. A., Finland M. In-vitro activity of carbenicillin and results of treatment of infections due to Pseudomonas with carbenicillin singly and in combination with gentamicin. J Infect Dis. 1970 Sep;122(Suppl):S14–S28. doi: 10.1093/infdis/122.supplement_1.s14. [DOI] [PubMed] [Google Scholar]
  14. Stevens P., Young L. S., Hewitt W. L. 125I-Radioimmunoassay of amikacin and comparison with a microbioassay. J Antibiot (Tokyo) 1976 Aug;29(8):829–832. doi: 10.7164/antibiotics.29.829. [DOI] [PubMed] [Google Scholar]
  15. Stevens P., Young L. S., Hewitt W. L. Radioimmunoassay, acetylating radio-enzymatic assay, and microbioassay of gentamicin: a comparative study. J Lab Clin Med. 1975 Aug;86(2):349–359. [PubMed] [Google Scholar]
  16. Stevens P., Young L. S. Simple method for elimination of aminoglycosides from serum to permit bioassay of other antimicrobial agents. Antimicrob Agents Chemother. 1977 Aug;12(2):286–287. doi: 10.1128/aac.12.2.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Weibert R., Keane W., Shapiro F. Carbenicillin inactivation of aminoglycosides in patients with severe renal failure. Trans Am Soc Artif Intern Organs. 1976;22:439–443. [PubMed] [Google Scholar]
  18. Winters R. E., Chow A. W., Hecht R. H., Hewitt W. L. Combined use of gentamicin and carbenicillin. Ann Intern Med. 1971 Dec;75(6):925–927. doi: 10.7326/0003-4819-75-6-925. [DOI] [PubMed] [Google Scholar]

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