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Risk factors for toxicity in elderly patients given aminoglycosides once daily

Abstract

OBJECTIVE: To determine the risk factors for aminoglycoside toxicity in the elderly.

DESIGN: Prospective observational study.

SETTING: Acute care teaching hospital serving predominantly veterans.

PARTICIPANTS: Consecutive patients aged 70 years and over receiving aminoglycosides.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Thirteen (15%) of 88 patients developed aminoglycoside-related nephrotoxicity and 3 (3.4%) developed otovestibular toxicity. Multivariate analysis showed that increasing duration of aminoglycoside therapy was the only factor significantly associated with development of toxicity. Elevated baseline serum creatinine level (p=.02) and use of allopurinol (p=.03) were risk factors specifically for nephrotoxicity. Only 2 (3.9%) of 51 patients receiving aminoglycosides 7 or fewer days developed nephrotoxicity, as compared with 11 (30%) of 37 receiving the drugs for 8 to 14 days and 4 (50%) of 8 treated for more than 14 days.

CONCLUSIONS: Although toxicity is common in elderly patients treated with aminoglycosides, limiting the duration of aminoglycoside therapy to less than a week can substantially reduce risk of toxicity.

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Paterson, D.L., Robson, J.M.B. & Wagener, M.M. Risk factors for toxicity in elderly patients given aminoglycosides once daily. J GEN INTERN MED 13, 735–739 (1998). https://doi.org/10.1046/j.1525-1497.1998.00224.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.1998.00224.x

Key words

  • aminoglycosides
  • gentamicin
  • nephrotoxicity
  • elderly