A randomized comparison of the safety and efficacy of once-daily Gentamicin or thrice-daily Gentamicin in combination with Ticarcillin-Clavulanate

Gilbert, David N.; Lee, Belle L.; Dworkin, Ronald J.; Leggett, James L; Chambers, Henry F.; Modin, Gunnard; Täuber, Martin G.; Sande, Merle A.

doi:10.1016/s0002-9343(98)00244-7

Cited by 39 publications

(16 citation statements)

References 40 publications

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“…Subsequent dosing was adjusted according to the serum concentration [22,23]. Peak and trough tobramycin serum concentrations were measured in both treatment arms subsequent to the third dose and after the first dose in patients with impaired renal function (estimated creatinine clearance Ͻ45 mL/h per the CockcroftGault equation) to assess treatment adequacy/toxicity prior to the achievement of a steady-state concentration.…”

Section: Administration Of Intravenous Tobramycin and Blinding Of Sermentioning

confidence: 99%

Aerosolized Tobramycin in The Treatment of Ventilator-Associated Pneumonia: A Pilot Study

Hallal

Cohn

Namias

et al. 2007

Surgical Infections

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Section: Administration Of Intravenous Tobramycin and Blinding Of Sermentioning

confidence: 99%

Aerosolized Tobramycin in The Treatment of Ventilator-Associated Pneumonia: A Pilot Study

Hallal

Cohn

Namias

et al. 2007

Surgical Infections

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“…In a more recent study, Gilbert et al compared Ticarcillin/Clavulanic acid, with gentamicin as single daily dose or divided three times a day in 175 patients hospitalized with serious infections, evaluating the safety and efficacy of a dose of gentamicin according to creatinine clearance. Clinical and microbiological efficacy were similar [25]. This association is an important recommendation as initial therapy for patients with serious infections [17].…”

Section: Discussionmentioning

confidence: 70%

Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma

Petrilli¹,

Cypriano²,

Dantas³

et al. 2003

Braz J Infect Dis

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Background. The empirical use of antibiotic treatments is widely accepted as a means to treat cancer patients in chemotherapy who have fever and neutropenia. Intravenous monotherapy, with broad spectrum antibiotics, of patients with a high risk of complications is a possible alternative. Methods. We conducted a prospective open-label, randomized study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients received either monotherapy with ticarcillin/clavulanic acid (T) or ceftriaxone plus amikacin (C+A). Results. Seventy patients who presented 136 episodes were evaluated, 68 in each arm of the study. The mean neutrophil counts at admission were 217cells/mm 3 (T) and 201cells/mm 3 (C+A). The mean duration of neutropenia was 8.7 days (T) and 7.6 days (C+A). Treatment was successful without the need for modifications in 71% of the episodes in the T group and 81% in the C+A group (p=0.23). Treatment was considered to have failed because of death in two episodes (3%) in the T group and three episodes (4%) in the C+A group, and because of a change in the drug applied in one episode in the T group and two episodes in the C+A group. Overall success was 96% (T) and 93% (C+A). Adverse events that occurred in group T were not related to the drugs used in this study. Conclusion. In pediatric and adolescent patients with leukemia or lymphoma, who presented with fever and neutropenia, during chemotherapy, ticarcillin/clavulanic acid was as successful as the combination of ceftriaxone plus amikacin. It should be considered an appropriate option for this group of patients at high risk for infections.

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“…Therefore, concentrations at 16 hours that were undetectable would be considered subtherapeutic. Concentrations greater than 2 mcg/mL at 16 hours after dose would be excessive, based on previously published nomograms [27, 28]. …”

Section: Methodsmentioning

confidence: 99%

Evaluation of Extended Interval Dosing Aminoglycosides in the Morbidly Obese Population

Ross

Tharp

Hobbs

et al. 2013

Advances in Pharmacological Sciences

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Aminoglycoside dosing has been studied in the obese population, typically recommending an adjusted weight utilizing a 40% dosing weight correction factor (IBW + 0.4 × (TBW–IBW)). These studies included limited numbers of morbidly obese patients and were not done in the era of extended interval aminoglycoside dosing. Here, we report a retrospective evaluation of morbidly obese patients receiving gentamicin or tobramycin at our hospital. The objective of this study was to evaluate the accuracy of the commonly recommended adjusted weight for weight-based dosing. There were 31 morbidly obese patients who received gentamicin or tobramycin 5–7 mg/kg every 24 hours using a 40% dosing weight correction factor. Our institution utilizes 16-hour postdose concentrations to monitor extended interval aminoglycosides. Twenty-two of the 31 patients (71%) achieved an appropriate serum drug concentration. Four patients (13%) were found to be supratherapeutic and 5 patients (16%) subtherapeutic. The only variable that correlated with supratherapeutic levels was older age (P = 0.0378). Our study helps to validate the current dosing weight correction factor (40%) in the morbidly obese population. We recommend caution when dosing aminoglycosides in morbidly obese patients who are of older age.

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A randomized comparison of the safety and efficacy of once-daily Gentamicin or thrice-daily Gentamicin in combination with Ticarcillin-Clavulanate

Cited by 39 publications

References 40 publications

Aerosolized Tobramycin in The Treatment of Ventilator-Associated Pneumonia: A Pilot Study

Aerosolized Tobramycin in The Treatment of Ventilator-Associated Pneumonia: A Pilot Study

Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma

Evaluation of Extended Interval Dosing Aminoglycosides in the Morbidly Obese Population

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