Aminoglycoside Toxicity

Mañá, Juan; Gatell, Josep-Maria; Araujo, V; Zamora, L.; SanMiguel, J G; Chandrasekar, D

doi:10.1016/s0140-6736(82)90694-8

Cited by 1 publication

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The lack of difference in the rates of nephrotoxicity between the two drugs (22.4 and 26% for tobramycin and amikacin, respectively) further supports the fact [15,16,25) that tobramycin and amikacin should be selected for reasons other than nephrotoxicity unless some difference can be demonstrated in a similar but larger trial.…”

Section: Discussionmentioning

confidence: 78%

“…No clear-cut differences in the rate of nephrotoxicity of amikacin and tobramycin, defined as an increase in serum creatinine, were found in our group of patients [15,16,25] in a trial [13] involving only patients with cancer and in a prospective nonrandomized trial [33] in which only 16 patients received amikacin. This is the first re ported trial in which tobramycin and amikacin were compared in a prospective randomized fashion, using a sensitive marker such as urinary concentration of p2m.…”

Section: Discussionmentioning

confidence: 94%

“…The rate of nephrotoxi city may be even higher in selected groups of patients [5,13,33,36,40,44] and may lead to acute renal failure, usually nonoliguric and reversible [3,5]. In fact, amino glycoside nephrotoxicity remains one of the major causes of acute renal failure in hospitalized patients [25,42]. Tubular damage is much more common [5,9,17,18,21,31,39,40] and can be demonstrated in almost all aminogly coside courses, provided a sensitive enough indicator is available [18,28,39].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Tobramycin and Amikacin Nephrotoxicity

Gatell¹,

SanMiguel²,

Zamora³

et al. 1985

Nephron

View full text Add to dashboard Cite

108 patients who received tobramycin or amikacin could be evaluated for nephrotoxicity in a prospective randomized trial. Both groups had similar illnesses, and causative agents, concurrent drug administration, ages, sex ratios, initial serum creatinine and aminoglycoside levels and total dose and duration of therapy. Using urinary concentration of β₂microglobulin (β₂m) as a marker, nephrotoxicity was detected in 13 (22.4%) of 58 patients given tobramycin and 13 (26%) of 50 given amikacin (n.s.). Using serum creatinine as a marker, nephrotoxicity was detected in 3 (5.2%) of 58 patients given tobramycin and in 7 (14%) of 50 given amikacin (n.s.). The whole group of 108 patients was used to compare the usefulness of serum creatinine levels versus urinary concentration of β₂m. An elevation of serum creatinine was detected in 10 of 108 patients (9.3%). In 5 of these 10 patients the β₂m remained normal, suggesting a functional renal failure. In 21 of the 108 patients (19.4%) the β₂m increased while the serum creatinine remained normal, suggesting an aminoglycoside nephrotoxicity which would have remained undetected if only serum creatinine had been measured. In the remaining patients (77 of the 108; 71.3%) serum creatinine and urinary concentration of β₂m both remained normal throughout the treatment. In conclusion no statistically significant differences were found between tobramycin and amikacin nephrotoxicity. Urinary β₂m is more sensitive than serum creatinine and furthermore it allows one to differentiate aminoglycoside nephrotoxicity from functional renal failure.

show abstract

Section: Discussionmentioning

confidence: 78%