How common is gentamicin toxicity?
Gentamicin ototoxicity, leading to hearing loss or deranged vestibular function, has been widely reported and is often irreversible. The prevalence of clinically evident ototoxicity with multiple daily regimens has been estimated at 11%.
Is gentamicin the least nephrotoxic?
For example, compared with tobramycin, gentamicin has relatively high tissue accumulation in the renal proximal tubules, explaining its increased nephrotoxic potential.
How can gentamicin nephrotoxicity be prevented?
To minimize the risk of nephrotoxicity, select loading and maintenance aminoglycoside dosages based on estimated creatinine clearance. Also, monitor peak and trough serum aminoglycoside levels, replenish volume, and correct potassium and magnesium abnormalities.
Is gentamicin safe in renal failure?
With regard to renal function, a single dose of gentamicin in patients with sepsis in the ED is safe. The development of AKI after admission was associated with shock, diabetes mellitus and higher baseline creatinine level.
How do you prevent nephrotoxicity?
Useful strategies to avoid nephrotoxicity from these drugs include using analgesics with less prostaglandin activity (acetaminophen, aspirin, sulindac, and nabumetone), correcting volume depletion before starting the drug, and monitoring renal function and vital signs when starting or increasing the dose of the drug.
Which aminoglycoside has the lowest risk of kidney toxicity?
Concentrations of the aminoglycosides in renal cortex and serum were not predictive of renal toxicity. Except for amikacin, which appeared to exhibit the lowest intrinsic renal toxicity, nephrotoxicity was correlated with the tubular reabsorption of each aminoglycoside.
How can nephrotoxicity be prevented?
General preventive measures include using alternative non-nephrotoxic drugs whenever possible; correcting risk factors, if possible; assessing baseline renal function before initiation of therapy, followed by adjusting the dosage; monitoring renal function and vital signs during therapy; and avoiding nephrotoxic drug …
Which is the most nephrotoxic aminoglycoside?
Choice of aminoglycoside The following rank order of nephrotoxicity has been reported, from most toxic to least toxic: neomycin > gentamicin ≥ tobramycin ≥ amikacin ≥ netilmicin > streptomycin .