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Infect Dis (Lond). 2016 Apr;48(4):274-280. doi: 10.3109/23744235.2015.1109136. Epub 2015 Nov 15.

No increased risk of acute kidney injury after a single dose of gentamicin in patients with sepsis.

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a Department of Internal Medicine , Maastricht University Medical Centre , Maastricht , The Netherlands.


Background Aminoglycosides are frequently used in the empirical treatment of sepsis. However, aminoglycosides may induce acute kidney injury (AKI). Data is lacking on the renal safety of a single dose of aminoglycosides in septic patients visiting the emergency department (ED). Aim To investigate the incidence of AKI in septic patients after a single dose of gentamicin (5 mg/kg) and to evaluate possible risk factors. Methods This study retrospectively followed patients, aged ≥ 18 years, visiting the ED and fulfilling sepsis criteria for 1 year. Two groups were analysed: septic patients receiving gentamicin in combination with beta-lactam antibiotics and a control group with pneumosepsis patients only without gentamicin. Renal function was determined prior to admission, at presentation and during the following 2 weeks. AKI was defined according to the RIFLE criteria. Results In total, 302 patients were included, 179 in the gentamicin and 123 in the control group. Mean gentamicin dose was 4.7 ± 0.7 mg/kg. At admission, 26.8% of the gentamicin and 16.3% of the control group had AKI. After admission, AKI occurred in 6.7% of the gentamicin and in 3.3% of the control group (p = 0.30). Occurrence of AKI was not associated with gentamicin administration, but with septic shock (31.2% in patients with AKI vs 9.8% without AKI after admission, p = 0.02). Conclusion This study showed no increased risk of AKI after a single dose of gentamicin to patients with sepsis in the ED, suggesting that a single dose of gentamicin can, with regard to renal function, be safely administered to septic patients.


Acute kidney injury; emergency department; gentamicin; nephrotoxicity; sepsis

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