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Does anyone have information regarding the ototoxic potential of an
isolated excessive gentamicin dose? I have heard that because of
"site-saturable" gentamicin binding to tissues, a modest peak is not
more ototoxic than a high peak, provided sufficient time is allowed for
wash out. I have found very limited information on literature searches
(two rodent model papers). If anyone knows of literature- including
review articles -that address this issue I would be very interested.
Thanks!
Tim G.
Tim
R. Timothy Gendron
PLL, Clinical Activities (0853)
Pharmacy Service
Charette Health Care Center
Naval Medical Center
620 John Paul Jones Circle
Portsmouth, Virginia 23708
Office (757) 953-0252
Pager (757) 669-3339
Fax (757) 953-0863
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The following message was posted to: PharmPK
Tim:
Very little risk. As a matter of fact, when I was still on F Troop at
UofI Chicago, George G. Jackson, M.D. was doing ID consults on one of
our patients. Based upon his lab and clinical experience (supported by
more recent studies on peak concentration effects of AGs), he suggested
a single dose that I latter figured probably yielded a Cmax of about 70
mg/L. He suggested that the high dose be used, then "let the clinical
pharmacist (me) make up his usual regimen, inferring of course (and
probably truthfully) that the lion's share of the antimicrobial effect
was going to come from his single dose, and not from my q8 dosing. In
fact, in retrospect, his single high dose was probably less nephrotoxic
and ototoxic than my (in those days) q8 dosing.
Paul
Paul Hutson, Pharm.D.
Associate Professor (CHS)
UW School of Pharmacy
777 Highland Avenue
Madison, WI 53705-2222
Tel: (608) 263-2496
FAX: (608) 265-5421
Pager: (608) 265-7000, #7856
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