Administration of gentamicin in a Dublin teaching hospital
Abstract number: 1135_54
O'Neill E., Humphreys H., Smyth E.
Appropriate use of antimicrobial therapy improves patient outcome and prevents the spread of antimicrobial resistance. It has been established that gentamicin should be administered at a dose of 5mg/kg in patients with normal renal function and for a shorter duration of therapy to improve bactericidal killing and post-antibiotic effect whilst reducing the risk of toxicity associated with prolonged treatment. We performed a prospective audit of gentamicin usage in our institution over a one month period.
Patients with normal renal function receiving gentamicin were identified from Clinical Microbiology team ward rounds, review of drug prescription charts, consultation with staff nurses and gentamicin assays done in the microbiology department. A member of the Clinical Microbiology team reviewed patients on a daily basis. Details including patient demographics, indications for treatment, dose administered and duration of treatment were obtained.
A total of 86 patients in our institution were on gentamicin therapy over the four week period with hospital acquired pneumonia (24.4%), intra-abdominal infection (23.2%) and neutropaenic sepsis (16.3%) accounting for the most common indications for therapy. 75% of patients were administered an inappropriate dose of gentamicin, of which 95% were being underdosed. One third of patients received a prolonged course of gentamicin therapy (i.e. longer than one week) in the absence of clinical or microbiological requirements.
This audit highlighted the high number of patients in our centre on inappropriate gentamicin therapy. In conjunction with the Microbiology and Pharmacy departments education sessions have been arranged for health care professionals to optimise gentamicin therapy and allow feedback on the findings of this audit.
|Session name:||XXIst ISTH Congress|
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