Guideline-Discordant Preoperative Gentamicin Dosing and the Risk of Gentamicin Associated Nephrotoxicity in Urologic Surgery.
Urology
; 153: 164-168, 2021 07.
Article
em En
| MEDLINE
| ID: mdl-33516831
ABSTRACT
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 ANDMETHODS:
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Procedimentos Cirúrgicos Urológicos
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Gentamicinas
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Antibioticoprofilaxia
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Fidelidade a Diretrizes
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Cálculos da Dosagem de Medicamento
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Nefropatias
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Guideline
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Urology
Ano de publicação:
2021
Tipo de documento:
Article