Infectious Diseases in Obstetrics and Gynecology

Infectious Diseases in Obstetrics and Gynecology / 1999 / Article

Open Access

Volume 7 |Article ID 383986 | https://doi.org/10.1155/S1064744999000216

C. Liu, B. Abate, M. Reyes, B. Gonik, "Single Daily Dosing of Gentamicin: Pharmacokinetic Comparison of Two Dosing Methodologies for Postpartum Endometritis", Infectious Diseases in Obstetrics and Gynecology, vol. 7, Article ID 383986, 5 pages, 1999. https://doi.org/10.1155/S1064744999000216

Single Daily Dosing of Gentamicin: Pharmacokinetic Comparison of Two Dosing Methodologies for Postpartum Endometritis

Received23 Oct 1998
Accepted01 Feb 1999

Abstract

Objective: We compared the pharmacokinetics of two methods for dosing gentamicin for the treatment of postpartum endometritis with the goal of achieving adequate peak serum concentrations (>12 mg/L) and prolonged trough levels below 2 mg/L.Methods: Group-I subjects (n = 5) received intravenous gentamicin, 5 mg/kg per total body weight over 60 min., with a maximum dose of 500 mg. Group-II subjects (n = 17) were dosed intravenously according to the following formula: Dose = desired peak concentration (fixed at 14 mg/L)* (volume of distribution, i.e., 0.35 L/kg)* adjusted body weight (in kilograms). Serum gentamicin levels were obtained 1 hr. and 8–12 hr. after infusion of the second dose. Pharmacokinetic parameters for the subjects in each group were calculated according to standard formulas.Results: Subjects in Group I had significantly higher doses and peak drug concentrations (P < 0.01), while in Group II, 76% of patients had peak levels less than desired (<12 mg/L). Both groups maintained trough levels of <2 mg/L in excess of 12 hr.Conclusions: Changing to the adjusted body weight formula for Group I, while maintaining a dose between 4 and 5 mg/kg, would reduce excessive peak concentrations. Using a calculated volume of distribution of 0.4 L/kg in Group II would improve peak serum concentrations to the desired levels. Both dosing regimens ensure adequate aminoglycoside pharmacokinetic parameters and avoid the need for monitoring serial serum drug concentrations, provided the expected clinical response is also achieved. While the first dosing formula is simpler to calculate, the second dosing formula allows for more individualized dosing considerations. Infect. Dis. Obstet. Gynecol. 7:133–137, 1999.

Copyright © 1999 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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