Key result
In post-operative patients with normal baseline renal function, gentamicin was associated with a significantly greater mean increase in serum creatinine (0.52 vs 0.32 mg/dL) and higher nephrotoxicity (32% vs 18%) compared to amikacin.
Why the study?
Does Amikacin compared to Gentamicin reduce nephrotoxicity in post-operative patients with normal baseline renal function?
Observational (n=100)
No
Does Amikacin compared to Gentamicin reduce nephrotoxicity in post-operative patients with normal baseline renal function?
Absolute Event Rate: 0.52% vs 0.32%
p-value: p=0.007
In post-operative patients, Gentamicin is associated with a higher risk of nephrotoxicity and a greater decline in creatinine clearance compared to Amikacin.
Gentamicin-associated nephrotoxicity may warrant caution in aminoglycoside selection post-operatively; leaves open confirmation by randomized trials.
Background: The majority of infections on any surgical ward are usually due to one or more of the gram-negative bacilli. Among the different groups of antimicrobials that have been used to treat these infections, Aminoglycoside antibiotics such as Amikacin and Gentamicin are the most commonly used.Methods: The study is 1 year, non-interventional, prospective study of patients administered either Amikacin or Gentamicin following surgery carried out in surgery ward in co-ordination with department of Pharmacology, Teerthanker Mahaveer Medical College and Research Centre Moradabad.Results: The mean difference in final and initial serum creatinine values were observed to be 0.32 and 0.52 with a standard deviation of 0.228 and 0.387 in AM and GM group respectively. This difference was statistically significant with p value of 0.007. The mean difference in final and initial creatinine clearance values were observed to be 18.82 and 24.76 with a standard deviation of 10.14 and 11.93 in AM and GM group respectively. This difference was also statistically significant with p-value of 0.013. Nephrotoxicity occurred in 9 out of 50 patients (18%) in AM group out of which 12% were male and 6% were female whereas in case of GM group nephrotoxicity occurred in 16 out of 50 patients (32%) in which 26% were male and 6% were female.Conclusions: From this study we can conclude that Gentamicin is more nephrotoxic and causes greater fall in creatinine clearance although the dose of Gentamicin administered is much lower compared to Amikacin.
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Bajracharya et al. (2016) conducted an observational in Post-operative infections (n=100). Gentamicin vs. Amikacin was evaluated on Mean difference in final and initial serum creatinine values (mg/dL) (p=0.007). In post-operative patients with normal baseline renal function, gentamicin was associated with a significantly greater mean increase in serum creatinine (0.52 vs 0.32 mg/dL) and higher nephrotoxicity (32% vs 18%) compared to amikacin.
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