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An evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice

BACKGROUND: Therapeutic drug monitoring and minimum inhibitory concentration (MIC) data allow more informed use of gentamicin. HYPOTHESIS/OBJECTIVES: To measure peak and trough serum gentamicin concentrations in horses after a 6.6 mg/kg dose of gentamicin given IV and the MIC of gentamicin of bacter...

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Autor principal: Durham, Andy E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980452/
https://www.ncbi.nlm.nih.gov/pubmed/29575239
http://dx.doi.org/10.1111/jvim.15078
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author Durham, Andy E.
author_facet Durham, Andy E.
author_sort Durham, Andy E.
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description BACKGROUND: Therapeutic drug monitoring and minimum inhibitory concentration (MIC) data allow more informed use of gentamicin. HYPOTHESIS/OBJECTIVES: To measure peak and trough serum gentamicin concentrations in horses after a 6.6 mg/kg dose of gentamicin given IV and the MIC of gentamicin of bacteria for which gentamicin might be selected. METHODS: Retrospective analysis of hospital records. Peak and trough plasma gentamicin concentrations were measured after 6.6 mg/kg gentamicin IV in 339 hospitalized horses. The MIC of gentamicin was measured for 503 isolates from ambulatory practice and 33 from hospital practice. The distribution of gentamicin concentrations and MIC results were compared to current recommendations for MIC breakpoints. RESULTS: The median serum gentamicin concentration at 60 minutes after administration (C (60min)) was 21.4 μg/mL with a distribution indicating that bacteria with MIC ≥2 μg/mL were unlikely to be exposed to sufficient gentamicin for effective killing. Approximately 90% of isolates from ambulatory practice and 36% of hospital isolates had MICs at or below breakpoints for susceptibility with most of the remainder unlikely to be responsive, even to higher IV doses. CONCLUSIONS AND CLINICAL IMPORTANCE: Gentamicin at a dosage of 6.6 mg/kg IV is likely to be effective against the majority of infections encountered in ambulatory practice, but less effective in an equine hospital. Because there was a dichotomy of most bacteria as being clearly susceptible or clearly resistant to gentamicin, it appears unlikely that higher doses would have been more efficacious, especially in the hospitalized population in our study.
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spelling pubmed-59804522018-06-06 An evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice Durham, Andy E. J Vet Intern Med EQUID BACKGROUND: Therapeutic drug monitoring and minimum inhibitory concentration (MIC) data allow more informed use of gentamicin. HYPOTHESIS/OBJECTIVES: To measure peak and trough serum gentamicin concentrations in horses after a 6.6 mg/kg dose of gentamicin given IV and the MIC of gentamicin of bacteria for which gentamicin might be selected. METHODS: Retrospective analysis of hospital records. Peak and trough plasma gentamicin concentrations were measured after 6.6 mg/kg gentamicin IV in 339 hospitalized horses. The MIC of gentamicin was measured for 503 isolates from ambulatory practice and 33 from hospital practice. The distribution of gentamicin concentrations and MIC results were compared to current recommendations for MIC breakpoints. RESULTS: The median serum gentamicin concentration at 60 minutes after administration (C (60min)) was 21.4 μg/mL with a distribution indicating that bacteria with MIC ≥2 μg/mL were unlikely to be exposed to sufficient gentamicin for effective killing. Approximately 90% of isolates from ambulatory practice and 36% of hospital isolates had MICs at or below breakpoints for susceptibility with most of the remainder unlikely to be responsive, even to higher IV doses. CONCLUSIONS AND CLINICAL IMPORTANCE: Gentamicin at a dosage of 6.6 mg/kg IV is likely to be effective against the majority of infections encountered in ambulatory practice, but less effective in an equine hospital. Because there was a dichotomy of most bacteria as being clearly susceptible or clearly resistant to gentamicin, it appears unlikely that higher doses would have been more efficacious, especially in the hospitalized population in our study. John Wiley and Sons Inc. 2018-03-25 2018 /pmc/articles/PMC5980452/ /pubmed/29575239 http://dx.doi.org/10.1111/jvim.15078 Text en Copyright © 2018 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle EQUID
Durham, Andy E.
An evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice
title An evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice
title_full An evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice
title_fullStr An evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice
title_full_unstemmed An evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice
title_short An evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice
title_sort evaluation of serum gentamicin concentrations and bacterial susceptibility to gentamicin in equine practice
topic EQUID
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980452/
https://www.ncbi.nlm.nih.gov/pubmed/29575239
http://dx.doi.org/10.1111/jvim.15078
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