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International Journal of Clinical Pharmacy

, Volume 40, Issue 3, pp 520–525 | Cite as

Monitoring of gentamicin serum concentrations in obstetrics and gynaecology patients in Namibia

  • Bonifasius S. Singu
  • Mwangana Mubita
  • Moses M. Thikukutu
  • Josef K. Mufenda
  • Shonag B. McKenzie
  • Roger K. Verbeeck
Research Article
  • 100 Downloads

Abstract

Background Therapeutic drug monitoring is frequently used to optimize the gentamicin dose. Objective The study investigated whether a 240 mg once daily standard dose achieves the recommended target serum gentamicin concentrations. Setting The prospective, observational study took place in the 2 major public hospitals in Namibia. Method Twenty-nine female patients receiving a standard dose (240 mg gentamicin once daily) participated in the study. Two blood samples were withdrawn to estimate gentamicin pharmacokinetic parameters. Serum creatinine was used to calculate creatinine clearance with the Cockcroft–Gault formula (CLcr), and estimate glomerular filtration rate (eGFR) by the Modified Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. Main outcome measure The outcome measure was the proportion of patients receiving 240 mg gentamicin once daily having Cmax values above 15 mg/L. Results Total body weight (TBW) and body mass index were highly variable: 43–115 kg, and 17.3–41.3 kg/m2, respectively. The gentamicin dose normalized for TBW (adjusted body weight for obese patients) was relatively low, i.e. 4.2 ± 0.8 mg/kg (mean SD). Gentamicin Cmax was 14.4 ± 4.7 mg/L; only 9 patients (31%) had a Cmax > 15 g/mL. eGFR (MDRD-4) correlated well with CLcr, but eGFR (EPI-CKD) formula showed systematic deviations from CLcr. Conclusions (1) a standard 240 mg dose results in gentamicin Cmax values below 15 mg/L in the majority of the patients, (2) eGFR formulas to estimate kidney function will have to be evaluated for their usefulness in the Namibian patient population.

Keywords

Gentamicin Gynaecology Kidney function Namibia Obsterics TDM Therapeutic drug monitoring 

Notes

Funding

None.

Conflicts of interest

None.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of PharmacyUniversity of NamibiaWindhoekNamibia
  2. 2.Windhoek Central Hospital and Katutura Intermediate Referral HospitalWindhoekNamibia

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