Guideline-Discordant Preoperative Gentamicin Dosing and the Risk of Gentamicin Associated Nephrotoxicity in Urologic Surgery
Copyright © 2021 Elsevier Inc. All rights reserved..
OBJECTIVE: To determine the rate of and predictors for guideline-discordant preoperative gentamicin dosing in urologic surgery and to assess the risk of nephrotoxicity in patients who receive the recommended high-dose prophylaxis.
MATERIALS AND METHODS: We retrospectively reviewed all adult patients who received preoperative gentamicin for urologic surgery from January 1, 2017 - October 3, 2019. Doses were categorized as guideline-concordant or -discordant using a cutoff of 4.5 mg/kg dosing weight. We used multivariable logistic regression to identify predictors for guideline-discordant dosing. Postoperative kidney injury was assessed using RIFLE criteria.
RESULTS: Among 2134 patients, 89% received a preoperative dose ≤ 4.5 mg/kg. Older age (70+ years) and endoscopic surgery were significant risk factors for guideline-discordant dosing (OR 2.54, P< 0.001; OR 6.21, P<0.001). Among 735 patients with complete data, there was no significant difference in the risk of kidney injury between those who received a dose less than 4.5 mg/kg and those who received a higher dose (OR 0.89, 95% CI: 0.26 - 2.99, P = 0.75).
CONCLUSION: Preoperative gentamicin is commonly administered at lower than recommended doses for urologic surgery. Older age and endoscopic surgery are significant predictors of guideline-discordant dosing. The risk of kidney injury following high-dose preoperative gentamicin for urologic procedures is likely comparable to the risk at lower doses.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:153 |
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| Enthalten in: |
Urology - 153(2021) vom: 25. Juli, Seite 164-168 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kurtzman, Jane T [VerfasserIn] |
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| Anmerkungen: |
Date Completed 09.02.2022 Date Revised 09.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.urology.2021.01.037 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM320781429 |
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| 500 | |a Date Revised 09.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To determine the rate of and predictors for guideline-discordant preoperative gentamicin dosing in urologic surgery and to assess the risk of nephrotoxicity in patients who receive the recommended high-dose prophylaxis | ||
| 520 | |a MATERIALS AND METHODS: We retrospectively reviewed all adult patients who received preoperative gentamicin for urologic surgery from January 1, 2017 - October 3, 2019. Doses were categorized as guideline-concordant or -discordant using a cutoff of 4.5 mg/kg dosing weight. We used multivariable logistic regression to identify predictors for guideline-discordant dosing. Postoperative kidney injury was assessed using RIFLE criteria | ||
| 520 | |a RESULTS: Among 2134 patients, 89% received a preoperative dose ≤ 4.5 mg/kg. Older age (70+ years) and endoscopic surgery were significant risk factors for guideline-discordant dosing (OR 2.54, P< 0.001; OR 6.21, P<0.001). Among 735 patients with complete data, there was no significant difference in the risk of kidney injury between those who received a dose less than 4.5 mg/kg and those who received a higher dose (OR 0.89, 95% CI: 0.26 - 2.99, P = 0.75) | ||
| 520 | |a CONCLUSION: Preoperative gentamicin is commonly administered at lower than recommended doses for urologic surgery. Older age and endoscopic surgery are significant predictors of guideline-discordant dosing. The risk of kidney injury following high-dose preoperative gentamicin for urologic procedures is likely comparable to the risk at lower doses | ||
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| 700 | 1 | |a Barone, Jussara C |e verfasserin |4 aut | |
| 700 | 1 | |a Aaron, Justin G |e verfasserin |4 aut | |
| 700 | 1 | |a Kubin, Christine J |e verfasserin |4 aut | |
| 700 | 1 | |a Anderson, Christopher B |e verfasserin |4 aut | |
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