Short course gentamicin therapy in patients with bacteremia was not associated with an increased incidence of acute kidney injury (AKI) and appears to be safe with regard to nephrotoxicity and mortality, according to study findings published in the European Journal of Clinical Microbiology & Infectious Diseases.
The risk for nephrotoxicity is a major concern when aminoglycosides are used in patients with sepsis, although the risk appears to be correlated with the duration of treatment. Studies to date have reported mixed results. In this study, the researchers compared renal function, renal recovery, and mortality in a cohort of 1404 patients with bacteremia, half of whom (n=702) were treated with daily gentamicin (≤3 days) and half (n=702) were not.
Using a modified version of the Kidney Disease: Improving Global Outcomes criteria for acute kidney injury, no significant differences were observed in the occurrence of acute kidney injury between the two groups (odds ratio (OR) .90; 95% CI, .68-1.20). The rate of recovery of renal function was also similar in both cohorts (OR 1.00; 95% CI, .63-1.60). No significant differences were noted in all-cause mortality between cohorts; the hazard ratio for 30-day all-cause mortality was 1.20 (95% CI, .94-1.55; P =.144), and for 90-day all-cause mortality it was 1.02 (95% CI 0.84-1.25; P =.814).
“Patients with sepsis are prone to develop acute kidney injury, and the cause is multifactorial,” the researchers concluded, adding that they did not find “gentamicin to be a triggering factor for acute kidney injury in this study.”
Carlsen S, Boel J, Jarløv JO, Gjørup I, Søborg C, Arpi M. The effect of short-course gentamicin therapy on kidney function in patients with bacteraemia-a retrospective cohort study [published online September 17, 2018]. Eur J Clin Microbiol Infect Dis. doi:10.1007/s10096-018-3376-6