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.
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:
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• Protocol articles from large randomized clinical trials
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