Tomáš Šálek, Josef Klhůfek, Martin Vodička, Marek Pšenčík
{"title":"Cystatin C for gentamicin dosing - a case study.","authors":"Tomáš Šálek, Josef Klhůfek, Martin Vodička, Marek Pšenčík","doi":"10.11613/BM.2025.030902","DOIUrl":null,"url":null,"abstract":"<p><p>The study aims to present a case study of a patient with supratherapeutic serum gentamicin concentration. An 83-year-old male was admitted to the Department of Internal Medicine for persistent loss of appetite, decompensated heart failure, and pneumonia. He was treated with 240 mg gentamicin daily alongside ampicillin/sulbactam penicillin antibiotic. The trough gentamicin concentrations and estimated glomerular filtration rate from creatinine (eGFRcrea) and cystatin C (eGFRcys) were performed. The patient had the supratherapeutic trough gentamicin concentration of 2.5 mg/L. eGFRcrea was 62 mL/min/1.73m<sup>2</sup> and eGFRcys was 25 mL/min/1.73m<sup>2</sup>. The difference between eGFRcrea and eGFRcys was 148%. Falsely high eGFRcrea in elderly patient led to the supratherapeutic gentamicin concentration even after the standard 240 mg gentamicin dose.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"35 3","pages":"030902"},"PeriodicalIF":1.8000,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334943/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Biochemia medica","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.11613/BM.2025.030902","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/15 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
The study aims to present a case study of a patient with supratherapeutic serum gentamicin concentration. An 83-year-old male was admitted to the Department of Internal Medicine for persistent loss of appetite, decompensated heart failure, and pneumonia. He was treated with 240 mg gentamicin daily alongside ampicillin/sulbactam penicillin antibiotic. The trough gentamicin concentrations and estimated glomerular filtration rate from creatinine (eGFRcrea) and cystatin C (eGFRcys) were performed. The patient had the supratherapeutic trough gentamicin concentration of 2.5 mg/L. eGFRcrea was 62 mL/min/1.73m2 and eGFRcys was 25 mL/min/1.73m2. The difference between eGFRcrea and eGFRcys was 148%. Falsely high eGFRcrea in elderly patient led to the supratherapeutic gentamicin concentration even after the standard 240 mg gentamicin dose.
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