Klin Farmakol Farm. 2014;28(2):55-58

Therapeutic drug monitoring as part of optimizing dosage regimens of gentamicin

Mária Göböová¹, Viera Kissová¹, Magdaléna Kuželová²

¹ Interná klinika, Fakultná nemocnica Nitra

² Katedra farmakológie a toxikológie, Farmaceutická fakulta Univerzity Komenského Bratislava

Purpose: To evaluate and analyze the importance of therapeutic monitoring levels of gentamicin in the optimization and individualization

of dosage regimens in patients with altered pharmacokinetics.

Patients and methods: Our retrospective study included 144 patients whose serum levels of gentamicin were measured at the time

of minimum and maximum concentrations before and after a possible dose adjustment in the years 2010–2012. Gentamicin concentrations

were measured with the Abbott AxSYM analyzer in the pharmacokinetic laboratory of the Nitra Teaching Hospital. The results

of therapeutic drug monitoring (TDM) were analyzed mainly in patients with altered pharmacokinetics.

Results: Seventeen (11.8%) patients had high trough levels and 108 patients (75%) had low peak levels. Only in 19 patients (13.2%)

both levels were optimal after the first measurement. Low peak levels occurred more often (79%) in overweight and obese patients.

The number of levels measured out of the therapeutic range was reduced significantly after interpretation of results and dose adjustment.

Conclusion: The results of assessment and analysis of therapeutic drug monitoring have shown its importance in the optimization

and individualization of dosage regimens, particularly in patients with altered pharmacokinetics, such as those with overweight, obesity

and those with augmented renal clearance.

Keywords: gentamicin, therapeutic drug monitoring, peak levels, obesity, augmented renal clearance

Published: July 1, 2014  Show citation