Short-term gentamicin therapy and risk of renal toxicity in patients with bacteraemia

Abstract The renal safety of gentamicin has been questioned even when dosed once daily. This retrospective cohort study comprised adult patients with community-acquired bacteraemia and no record of chronic renal disease or malignancy. We included patients treated with gentamicin once daily for ≤ 5 days (165 exposed patients) and a balanced sample of patients not receiving aminoglycosides (150 non-exposed patients). The primary endpoint, which was an elevation in plasma creatinine of > 40 μmol/l from baseline, was equally common among exposed (7.9%) and non-exposed patients (8.7%) (p = 0.80). Among 26 patients with the primary endpoint, follow-up creatinine levels were evaluable in 21 patients and reached the normal range in 8/12 (67%) exposed patients and in 7/9 (78%) non-exposed patients (p = 0.66). Thirty-day mortality was 7.9% in exposed patients versus 7.3% in non-exposed patients (p = 0.86). We conclude that renal impairment in bacteraemic patients is independent of short-term (≤ 5 days) gentamicin administration.