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Determination of Serum Gentamicin Sulfate Levels: Ordering Patterns and Use as a Guide to Therapy

Determination of Serum Gentamicin Sulfate Levels: Ordering Patterns and Use as a Guide to Therapy Abstract Determination of serum gentamicin levels (SGLs) is helpful in monitoring therapy in patients receiving this drug because there is a narrow therapeutic margin and serum levels may vary greatly between patients receiving similar doses. During a ten-month period, definite indications for obtaining SGL determinations were present for 189 of 212 serum samples (89.2%) submitted to the laboratory. However, 110 samples (51.9%) were improperly drawn and results of 85 samples (40.1%) were ignored. Only 26 of the 62 correctly drawn and not ignored samples (41.9%) were appropriately acted on. At most, 42 of the 212 samples (19.8%) were appropriately used in making patient-care decisions. Thus, in this study, an inordinately large number of SGLs were incorrectly drawn, apparently ignored, or inappropriately used in making patient-care decisions. (Arch Intern Med 136:785-787, 1976) References 1. Koch-Weser J: Serum drug concentrations as therapeutic guides . N Engl J Med 287:227-231, 1972.Crossref 2. Barza M, Brown RB, Shen D, et al: Predictability of blood levels of gentamicin in man . J Infect Dis 132:165-174, 1975.Crossref 3. McHenry MC, Gavan TL, Gifford RW Jr, et al: Gentamicin dosages for renal insufficiency: Adjustments based on endogenous creatinine clearance and serum creatinine concentration . Ann Intern Med 74:192-197, 1971.Crossref 4. Riff LJ, Jackson GG: Pharmacology of gentamicin in man . J Infect Dis 124 ( (suppl 124) ):598-605, 1971.Crossref 5. Winters RE, Litwack KD, Hewitt WL: Relation between dose and levels of gentamicin in blood . J Infect Dis 124 ( (suppl 124) ):590-595, 1971.Crossref 6. Kaye D, Levison ME, Labovitz ED: The unpredictability of serum concentrations of gentamicin: Pharmacokinetics of gentamicin in patients with normal and abnormal renal function . J Infect Dis 130:150-154, 1974.Crossref 7. Jackson GG, Riff LJ: Pseudomonas bacteremia: Pharmacologic and other bases for failure of treatment with gentamicin . J Infect Dis 124 ( (suppl 124) ):185-191, 1971.Crossref 8. Dahlgren JG, Anderson ET, Hewitt WL: Gentamicin blood levels: A guide to nephrotoxicity . Antimicrob Agents Chemother 8:58-62, 1975.Crossref 9. Jackson GG: Laboratory and clinical investigations of gentamicin , in Gentamicin: First International Symposium . Basel, Switzerland, Schwabe, 1967, pp 62-74. 10. Sabath LD, Casey JI, Ruch PA, et al: Rapid microassay of gentamicin, kanamycin, neomycin, streptomycin and vancomycin in serum or plasma . J Lab Clin Med 78:457-467, 1971. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Determination of Serum Gentamicin Sulfate Levels: Ordering Patterns and Use as a Guide to Therapy

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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1976.03630070033010
Publisher site
See Article on Publisher Site

Abstract

Abstract Determination of serum gentamicin levels (SGLs) is helpful in monitoring therapy in patients receiving this drug because there is a narrow therapeutic margin and serum levels may vary greatly between patients receiving similar doses. During a ten-month period, definite indications for obtaining SGL determinations were present for 189 of 212 serum samples (89.2%) submitted to the laboratory. However, 110 samples (51.9%) were improperly drawn and results of 85 samples (40.1%) were ignored. Only 26 of the 62 correctly drawn and not ignored samples (41.9%) were appropriately acted on. At most, 42 of the 212 samples (19.8%) were appropriately used in making patient-care decisions. Thus, in this study, an inordinately large number of SGLs were incorrectly drawn, apparently ignored, or inappropriately used in making patient-care decisions. (Arch Intern Med 136:785-787, 1976) References 1. Koch-Weser J: Serum drug concentrations as therapeutic guides . N Engl J Med 287:227-231, 1972.Crossref 2. Barza M, Brown RB, Shen D, et al: Predictability of blood levels of gentamicin in man . J Infect Dis 132:165-174, 1975.Crossref 3. McHenry MC, Gavan TL, Gifford RW Jr, et al: Gentamicin dosages for renal insufficiency: Adjustments based on endogenous creatinine clearance and serum creatinine concentration . Ann Intern Med 74:192-197, 1971.Crossref 4. Riff LJ, Jackson GG: Pharmacology of gentamicin in man . J Infect Dis 124 ( (suppl 124) ):598-605, 1971.Crossref 5. Winters RE, Litwack KD, Hewitt WL: Relation between dose and levels of gentamicin in blood . J Infect Dis 124 ( (suppl 124) ):590-595, 1971.Crossref 6. Kaye D, Levison ME, Labovitz ED: The unpredictability of serum concentrations of gentamicin: Pharmacokinetics of gentamicin in patients with normal and abnormal renal function . J Infect Dis 130:150-154, 1974.Crossref 7. Jackson GG, Riff LJ: Pseudomonas bacteremia: Pharmacologic and other bases for failure of treatment with gentamicin . J Infect Dis 124 ( (suppl 124) ):185-191, 1971.Crossref 8. Dahlgren JG, Anderson ET, Hewitt WL: Gentamicin blood levels: A guide to nephrotoxicity . Antimicrob Agents Chemother 8:58-62, 1975.Crossref 9. Jackson GG: Laboratory and clinical investigations of gentamicin , in Gentamicin: First International Symposium . Basel, Switzerland, Schwabe, 1967, pp 62-74. 10. Sabath LD, Casey JI, Ruch PA, et al: Rapid microassay of gentamicin, kanamycin, neomycin, streptomycin and vancomycin in serum or plasma . J Lab Clin Med 78:457-467, 1971.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1976

References