A fatal outcome due to a continuous dosage of gentamicin: a case report

Abstract

Gentamicin, an aminoglycoside antibiotic, exerts its bactericidal effect primarily through the inhibition of ribosomes in Gram-negative bacteria. It has a concentration-dependent pharmacodynamic effect, making an extended-interval dosage preferable. The total dose is, therefore, usually administered as a single daily dose instead of divided portions two or three times a day. This dosage has shown an excellent efficacy because an appropriate peak concentration is obtained, whilst the risk of nephrotoxicity is reduced as this is correlated with the residual concentration of gentamicin. In the European Medicines Agencies Summary of Products Characteristics, it is stated that deterioration of kidney function could be expected in 1/10 to 1/100 patients treated with gentamicin. We present a 92-year-old female patient with a weight of 39 kg, history of chronic kidney disease (CKD) and chronic heart failure that presented a fatal nephrotoxicity due to a prescription error of gentamicin.