This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (27)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Limitations in Intensive Care Unit—Related Bacterial Pneumonia

Lewis M. Flint, MD; John Gott, MD; Lisa Short, RPh; J. David Richardson, MD; Hiram C. Polk, Jr, MD

Arch Surg. 1985;120(1):99-103.

Abstract
• Serum aminoglycoside assays have been accepted as useful methods of enhancing therapeutic efficacy in the treatment of intensive care unit-acquired pneumonia and in avoiding aminoglycoside nephrotoxicity. We prospectively studied 68 surgical patients with normal renal function and gram-negative bacterial pneumonia who were treated with aminoglycosides. Serum levels indicated subtherapeutic levels in 47 patients and verified optimum levels in 13 patients. Toxic trough levels developed in six patients and, despite immediate dosage adjustment, five patients suffered nephrotoxicity. Six additional patients also had nephrotoxicity. Five of these patients never had toxic peak or trough levels and rising trough levels developed in one patient after serum creatinine levels began to rise. We conclude that routine monitoring of serum levels effectively detects subtherapeutic antibiotic levels. This modality is useful for optimizing dosage schedules, but does not serve to predict or avoid nephrotoxicity in critically ill surgical patients.

(Arch Surg 1985;120:99-103)

Author Affiliations
From the Department of Surgery, University of Louisville School of Medicine.

Footnotes
Accepted for publication Sept 20, 1984.

Read before the Fourth Annual Meeting of the Surgical Infection Society, Montreal, May 1, 1984.

Reprint requests to Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292 (Dr Flint).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Extended-Interval Dosing of Aminoglycoside Antibiotics in Critically Ill Patients
Fish
Journal of Pharmacy Practice 2002;15:85-95.
ABSTRACT  

Isepamicin in intensive care unit patients with nosocomial pneumonia: population pharmacokinetic–pharmacodynamic study
Tod et al.
J Antimicrob Chemother 1999;44:99-108.
ABSTRACT | FULL TEXT