P-17 AMIKACIN USE AND RISK OF NEPHROTOXICITY IN PATIENTS WITH LIVER CIRRHOSIS HOSPITALIZED FOR SEPSIS

Abstract

Conflict of interest

No

Introduction and Objectives

Aminoglycosides are a group of broad-spectrum antibiotics, which have action especially against gram-negative bacteria. It is associated with nephrotoxicity in 10-20% of cases, a figure that increases in patients with liver cirrhosis. Amikacin is frequently used in sepsis, with little information about the risk of nephrotoxicity in cirrhosis. The aim was to determine the association between amikacin use and renal function deterioration in patients with liver cirrhosis and sepsis.

Patients / Materials and Methods

Retrospective, observational, analytical study in patients with liver cirrhosis of any etiology, who required hospitalization for sepsis between 2017 and 2023, and who received antibiotic therapy. An increase in serum creatinine ≥ 0.3 mg/dl in the first 7 days of hospitalization was used as a marker of renal function deterioration. Clinical variables, renal failure and mortality were compared between patients who received amikacin and those who did not. Stata 13.0 was used for data analysis with a statistical significance of 0.05.

Results and Discussion

In this study 228 patients were included, median age 65 years (54-70), 100 (44%) women, 70 received amikacin (31%). Renal function deterioration was present in 25 (36%) patients with amikacin and 33 (21%) without amikacin. In patients with initial serum creatinine > 2.0 mg/dl and in those with Child-Pugh C cirrhosis, the probability of developing renal function deterioration was higher in those who received Amikacin (OR 7.5; 95% CI 1.1 – 48.0, p= 0.031 and OR 2.51; 95% CI 1.06 – 5.97, p = 0.036, respectively). A comparative table of different subgroups is attached.

Conclusions

The use of amikacin was associated with renal function deterioration in patients with liver cirrhosis and sepsis, mainly in Child-Pugh C cirrhosis and with initial serum creatinine > 2.0 mg/dl.