Abstract
The pharmacokinetics of gentamicin were investigated in 880 patients with leukemia (24 patients), other malignancies (211 patients), or no malignancies (645 patients) by using data collected by our Clinical Pharmacy Service. A significant difference was seen in the initial calculated creatinine clearance between the patients with leukemia and the other two groups. No differences in gentamicin pharmacokinetics were seen in patients with other malignancies versus those with no malignancies. Patients with leukemia had significantly faster drug clearance compared with those in the other two groups. A poor predictive value was found for total body clearance of gentamicin versus the initial calculated creatinine clearance in all groups. Multiple logistic regression analysis showed that only the initial calculated creatinine clearance differed in the leukemic group compared with those in the other patients. Our data suggest that no pharmacokinetic difference exists for gentamicin in patients with malignancies.
Full text
PDF


Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bianco T. M., Dwyer P. N., Bertino J. S., Jr Gentamicin pharmacokinetics, nephrotoxicity, and prediction of mortality in febrile neutropenic patients. Antimicrob Agents Chemother. 1989 Nov;33(11):1890–1895. doi: 10.1128/aac.33.11.1890. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bodey G. P. Antibiotics in patients with neutropenia. Arch Intern Med. 1984 Sep;144(9):1845–1851. [PubMed] [Google Scholar]
- Carr M. R., Dick S. P., Bordley J., 4th, Bertino J. S., Jr Gentamicin dosing requirements in patients with acute pancreatitis. Surgery. 1988 May;103(5):533–537. [PubMed] [Google Scholar]
- Cockcroft D. W., Gault M. H. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41. doi: 10.1159/000180580. [DOI] [PubMed] [Google Scholar]
- Levy J., Smith A. L., Koup J. R., Williams-Warren J., Ramsey B. Disposition of tobramycin in patients with cystic fibrosis: a prospective controlled study. J Pediatr. 1984 Jul;105(1):117–124. doi: 10.1016/s0022-3476(84)80375-3. [DOI] [PubMed] [Google Scholar]
- Manny R. P., Hutson P. R. Aminoglycoside volume of distribution in hematology-oncology patients. Clin Pharm. 1986 Aug;5(8):629–632. [PubMed] [Google Scholar]
- Moore R. D., Lietman P. S., Smith C. R. Clinical response to aminoglycoside therapy: importance of the ratio of peak concentration to minimal inhibitory concentration. J Infect Dis. 1987 Jan;155(1):93–99. doi: 10.1093/infdis/155.1.93. [DOI] [PubMed] [Google Scholar]
- Moore R. D., Smith C. R., Lietman P. S. The association of aminoglycoside plasma levels with mortality in patients with gram-negative bacteremia. J Infect Dis. 1984 Mar;149(3):443–448. doi: 10.1093/infdis/149.3.443. [DOI] [PubMed] [Google Scholar]
- Phillips J. K., Spearing R. L., Crome D. J., Davies J. M. Gentamicin volumes of distribution in patients with hematologic disorders. N Engl J Med. 1988 Nov 10;319(19):1290–1290. doi: 10.1056/NEJM198811103191918. [DOI] [PubMed] [Google Scholar]
- Sawchuk R. J., Zaske D. E. Pharmacokinetics of dosing regimens which utilize multiple intravenous infusions: gentamicin in burn patients. J Pharmacokinet Biopharm. 1976 Apr;4(2):183–195. doi: 10.1007/BF01086153. [DOI] [PubMed] [Google Scholar]
- Sculier J. P., Klastersky J. Significance of serum bactericidal activity in gram-negative bacillary bacteremia in patients with and without granulocytopenia. Am J Med. 1984 Mar;76(3):429–435. doi: 10.1016/0002-9343(84)90662-4. [DOI] [PubMed] [Google Scholar]
- Zaske D. E., Cipolle R. J., Strate R. G., Dickes W. F. Increased gentamicin dosage requirements: rapid elimination in 249 gynecology patients. Am J Obstet Gynecol. 1981 Apr 15;139(8):896–900. doi: 10.1016/0002-9378(81)90954-6. [DOI] [PubMed] [Google Scholar]
- Zaske D. E., Sawchuk R. J., Strate R. G. The necessity of increased doses of amikacin in burn patients. Surgery. 1978 Nov;84(5):603–608. [PubMed] [Google Scholar]
- Zeitany R. G., El Saghir N. S., Santhosh-Kumar C. R., Sigmon M. A. Increased aminoglycoside dosage requirements in hematologic malignancy. Antimicrob Agents Chemother. 1990 May;34(5):702–708. doi: 10.1128/aac.34.5.702. [DOI] [PMC free article] [PubMed] [Google Scholar]