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
{"title":"Nephrotoxicity associated with short-term gentamicin therapy in community-acquired bacteraemia: risk of nephrotoxicity.","authors":"Oliver Wagner Ulf Nielsen, Mikkel Oliver Skov Risom, Hans Linde Nielsen, Jacob Bodilsen, Henrik Nielsen","doi":"10.61409/A08240568","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Hesitancy towards the use of aminoglycosides persists among clinicians due to the perceived risk of nephrotoxicity.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 3","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Danish medical journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.61409/A08240568","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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.

求助全文
约1分钟内获得全文 求助全文
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信