The association of aminoglycoside plasma levels with mortality in patients with gram-negative bacteremia

R. D. Moore, C. R. Smith, P. S. Lietman

Research output: Contribution to journalArticlepeer-review

Abstract

To determine the association of aminoglycoside levels with mortality from gram-negative bacteremia, we analyzed the case reports of patients from four prospective, randomized and controlled clinical trials of gentamicin tobramycin, and amikacin. Twelve (13.5%) of 89 patients died. One (2.4%) death occurred in 41 patients with early (1-hr postinfusion) peak concentrations of >5 μg/ml of gentamicin and tobramycin and of >20 μg of amikacin/ml; nine deaths (20.9%) occurred in 43 patients with lower concentrations. Five (8.3%) deaths occurred in 60 patients with mean peak concentrations for the entire course of therapy of >5 μg/ml of gentamicin and tobramycin and of >20 μg of amikacin/ml; five (20.8%) deaths occurred in 24 patients with lower concentrations. Stepwise discriminant analysis showed that therapeutic early peak concentration was a significant factor in the presence of three other factors; severity of underlying illness, peak temperature, and initial leukocyte count. The results suggest the importance of achieving adequate early aminoglycoside levels in patients with gram-negative bacteremia.

Original languageEnglish (US)
Pages (from-to)443-448
Number of pages6
JournalJournal of Infectious Diseases
Volume149
Issue number3
DOIs
StatePublished - 1984

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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