Gentamicin Therapy in Renal Failure: A Nomogram for Dosage

Gentamicin has been given to patients with compromised renal function or severe renal failure, in toxic or nearly toxic peak serum concentrations followed by long periods of subinhibitory serum levels. A nomogram to allow safe, inhibitory serum gentamicin levels (3 to 8 µg/ml) in a steady-state manner was developed. The nomogram regimen is based on an elimination constant (K2) for 8-hour periods, as developed from half-life values at various levels of Seventeen patients with renal failure and life-threatening infections caused by Gram-negative bacilli were treated according to the nomogram. All the infections were controlled, and serum gentamicin concentrations that were inhibitory yet nontoxic were documented in all patients, including two who had repeated hemodialysis.