Work

Recommended gentamicin peak plasma levels rarely reached, even with recommended dosages

Year: 2025

Type: article

Abstract: • This is the largest study on gentamycin peak concentration (601 samples). • Only a small proportion (5.7 %) of values exceeded the minimal recommended value. • Even with high gentamycin dose (>10 mg/kg), only 22.7 % of the values reached the target concentration. • These results suggest that target concentration limits are unrealistic. The recommended gentamicin peak plasma concentration range is 32–40 mg/L; we aimed to determine how frequently it was reached, and for which gentamicin doses. We retrospectively reviewed 601 gentamicin peak plasma concentrations in 501 patients aged ≥15 in our institution between 2013 and 2023. Median gentamicin dose was 5.9 mg/kg [IQR 4.1–7.9]. Median peak plasma concentration was 16.5 mg/L [IQR 10.8–22.8] and was strongly correlated with dose (p < 0.0001). Only 5.7 % of values were ≥32 mg/L, including 22.8 % for dose ≥10 mg/kg. This suggests that existing recommendations regarding either dose or target concentration for gentamicin should be modified.

Source: Infectious Diseases Now

DOI: 10.1016/j.idnow.2025.105076