Nephrotoxicity associated with short-term gentamicin therapy in community-acquired bacteraemia: risk of nephrotoxicity.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Oliver Wagner Ulf Nielsen, Mikkel Oliver Skov Risom, Hans Linde Nielsen, Jacob Bodilsen, Henrik Nielsen
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引用次数: 0

Abstract

Introduction: Hesitancy towards the use of aminoglycosides persists among clinicians due to the perceived risk of nephrotoxicity.

Methods: This retrospective cohort study included adults with community-acquired bacteraemia and no pre-existing renal failure. The patients were divided into two groups matched 1:1 by age (± 5 years): 1) patients treated with short-term (≤ 3 days) once-daily gentamicin within 24 hours of admission and 2) non-gentamicin-treated patients. The primary endpoint was an increase in plasma creatinine levels of ≥ 40 µmol/l from baseline. Cause-specific Cox regression was used to compute hazard ratios (HR) with 95% confidence intervals (CI) for prognostic factors of acute kidney injury (AKI) and death.

Results: A total of 310 adults with bacteraemia were included, among whom 159 (49%) were treated with gentamicin and 151 (51%) with other antibiotics. No significant between-group differences were observed in sex distribution, comorbidities, biochemical variables and vital signs at admission. In the gentamicin-exposed group, 11 (7%) patients developed AKI compared with 12 (8%) patients in the non-exposed group. Gentamicin was neither associated with increased risk of AKI (HR = 0.86; 95% CI: 0.38-1.96) nor with 30-day mortality (HR = 0.73; 95% CI: 0.38-1.41) compared with other antibiotic regimens.

Conclusions: Our study showed no increase in the risk of developing AKI and no increase in all-cause mortality in patients treated with short-term once-daily gentamicin for community-acquired bacteraemia compared with other antibiotic regimens.

Funding: None.

Trial registration: Not relevant.

社区获得性菌血症患者短期庆大霉素治疗相关肾毒性:肾毒性风险
简介:临床医生对氨基糖苷类药物的使用犹豫不决,因为他们认为存在肾毒性风险。方法:这项回顾性队列研究纳入了社区获得性菌血症且无既往肾衰竭的成年人。患者按年龄(±5岁)按1:1比例分为两组:1)入院24小时内短期(≤3天)每日1次庆大霉素治疗组和2)未使用庆大霉素治疗组。主要终点是血浆肌酐水平较基线升高≥40µmol/l。病因特异性Cox回归用于计算急性肾损伤(AKI)和死亡预后因素的95%可信区间(CI)的风险比(HR)。结果:共纳入310例成人菌血症患者,其中庆大霉素治疗159例(49%),其他抗生素治疗151例(51%)。两组间性别分布、合并症、生化指标及入院时生命体征均无显著差异。在庆大霉素暴露组中,11例(7%)患者发生AKI,而未暴露组为12例(8%)。庆大霉素与AKI风险增加无关(HR = 0.86;95% CI: 0.38-1.96)与30天死亡率无关(HR = 0.73;95% CI: 0.38-1.41)与其他抗生素方案相比。结论:我们的研究显示,与其他抗生素方案相比,每日一次短期庆大霉素治疗社区获得性菌血症的患者发生AKI的风险没有增加,全因死亡率也没有增加。资金:没有。试验注册:不相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Danish medical journal
Danish medical journal MEDICINE, GENERAL & INTERNAL-
CiteScore
2.30
自引率
6.20%
发文量
78
审稿时长
3-8 weeks
期刊介绍: The Danish Medical Journal (DMJ) is a general medical journal. The journal publish original research in English – conducted in or in relation to the Danish health-care system. When writing for the Danish Medical Journal please remember target audience which is the general reader. This means that the research area should be relevant to many readers and the paper should be presented in a way that most readers will understand the content. DMJ will publish the following articles: • Original articles • Protocol articles from large randomized clinical trials • Systematic reviews and meta-analyses • PhD theses from Danish faculties of health sciences • DMSc theses from Danish faculties of health sciences.
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