What is it about?
Gentamicin is a front line antibiotic of choice in treating peritoneal infections due to gram negative bacteria in people on peritoneal dialysis (PD). Dosage protocols are based on drug absorption in healthy peritoneal membranes. This is the first study of absorption of gentamicin by inflamed peritoneal membranes in people with PD peritonitis. We found more gentamicin is absorbed compared to the reports in the literature across the non-inflammed peritoneum of PD patients.
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Why is it important?
The international guidelines on the treatment of PD peritonitis are based on the earlier evidence generated in non-inflamed peritoneal membranes. The finding in this study is systemic gentamicin exposure is greater, increasing the known risks of this drug. The option is modifying current guidelines taking into account the bioefficacy of gentamicin, ie high peak drug concentrations effect maximal bacterial killing and a prolonged postantibiotic effect.
Perspectives
The findings of our study have alerted me to the risks of gentamicin toxicity in my PD patients with gram negative peritonitis.
Dr Helen G HEALY
Royal Brisbane and Women's Hospital
Read the Original
This page is a summary of: Pharmacokinetics of Intraperitoneal Gentamicin in Peritoneal Dialysis Patients with Peritonitis (GIPD Study), Clinical Journal of the American Society of Nephrology, June 2012, American Society of Nephrology,
DOI: 10.2215/cjn.12211211.
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