Initial low-dose gentamicin for Staphylococcus aureus bacteremia and endocarditis is nephrotoxic.
Journal Article (Journal Article;Multicenter Study)
BACKGROUND: The safety of adding initial low-dose gentamicin to antistaphylococcal penicillins or vancomycin for treatment of suspected Staphylococcus aureus native valve endocarditis is unknown. This study evaluated the association between this practice and nephrotoxicity. METHODS: We performed a prospective cohort study of safety data from a randomized, controlled trial of therapy for S. aureus bacteremia and native valve infective endocarditis involving 236 patients from 44 hospitals in 4 countries. Patients either received standard therapy (antistaphylococcal penicillin or vancomycin) plus initial low-dose gentamicin (n=116) or received daptomycin monotherapy (n = 120). We measured renal adverse events and clinically significant decreased creatinine clearance in patients (1) in the original randomized study arms and (2) who received any initial low-dose gentamicin either, as a study medication or or=65 years and receipt of any initial low-dose gentamicin. CONCLUSIONS: Initial low-dose gentamicin as part of therapy for S. aureus bacteremia and native valve infective endocarditis is nephrotoxic and should not be used routinely, given the minimal existing data supporting its benefit.
Full Text
Duke Authors
Cited Authors
- Cosgrove, SE; Vigliani, GA; Fowler, VG; Abrutyn, E; Corey, GR; Levine, DP; Rupp, ME; Chambers, HF; Karchmer, AW; Boucher, HW
Published Date
- March 15, 2009
Published In
- Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Volume / Issue
- 48 / 6
Start / End Page
- 713 - 721
PubMed ID
- 19207079
Electronic International Standard Serial Number (EISSN)
- 1537-6591
Digital Object Identifier (DOI)
- 10.1086/597031
Language
- eng
Conference Location
- United States