Waleed M. Sweileh

Associate Professor, Clinical Pharmacology, An-Najah National University, Nablus, Palestine.

Abstract

Objective: The present study aimed to determine the time course of aminoglycoside-induced serum creatinine (SCr) elevation and compare that in patients treated with amikacin (AK) and those treated with gentamicin (GM).

Methodology: A one-year, non-interventional prospective study of patients with normal baseline renal function and were administered either GM or AK. The study was carried out at the internal medicine department of Al-Watani governmental hospital. Outcome of interest was the time course of serum creatinine elevation during the course of aminoglycoside therapy. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS 16).

Results: The study was performed in 94 patients, who had to be administered GM or AK by intravenous injections. In both groups, the significant rise in SCr was detected on the 4th day of therapy. However, GM induced up to 32% increase while AK induced up to 19.5% increase in SCr from baseline levels. In the course of AK treatment, patients on single dosing frequency and those <65 years of age did not show a significant increase in SCr levels during the 6-day therapy. In the course of GM therapy, patients on single frequency dosing, younger patients and females showed a significant elevation in SCr on the 5th day while elderly, males and those on multiple dosing showed a significant elevation on the 4th day of therapy. However, all patient categories on GM therapy showed similar extent of SCr elevation.

Conclusion: In patients with normal renal function, GM and AK showed similar time course but different extent of SCr elevation. Amikacin induced no SCr elevation when given in single dosing frequency or when given to younger patients. Such effects were not observed with GM.