ArticleThe Journal of antimicrobial chemotherapy2020
Dose recommendations for gentamicin in the real-world obese population with varying body weight and renal (dys)function.
Article in The Journal of antimicrobial chemotherapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Bibliometric analysis of global research on the clinical applications of aminoglycoside antibiotics: improving efficacy and decreasing risk.Frontiers in microbiology · 2025Pooled it
- Updated antimicrobial dosing recommendations for obese patients.Antimicrobial agents and chemotherapy · 2024Pooled it
- How to Dose Vancomycin in Overweight and Obese Patients with Varying Renal (Dys)function in the Novel Era of AUC 400-600 mg·h/L-Targeted Dosing.Clinical pharmacokinetics · 2024Trial
- One Model to Dose Them All: A Population Pharmacokinetic Model for Multiple Aminoglycosides Across the Human Lifespan.Journal of clinical pharmacology · 2026Article
- The "obesity paradox" in dosing: a comprehensive analytical review of cockcroft-gault versus CKD-EPI for predicting clearance of narrow-therapeutic-index drugs in patients with BMI > 40 kg/m².European journal of clinical pharmacology · 2026Review
- Antimicrobial Pharmacokinetic and Pharmacodynamic Considerations in Special Populations: A Call to Action.Open forum infectious diseases · 2026Review
- Performance of Estimated Kidney Function Equations for Predicting Aminoglycosides Clearance in Thai Population.Journal of clinical pharmacology · 2026Article
- The Impact of Drug Properties and Severity of Obesity on Renal Drug Clearance Through Glomerular Filtration and Active Tubular Secretion: A Systematic Analysis Using PBPK Modeling.Pharmaceutical research · 2025Article
- Individual pharmacokinetic parameter estimation of gentamicin in an obese hemodialysis patient using non-linear mixed effect model.Translational and clinical pharmacology · 2024Article
- Risk Factors Associated with Antibiotic Exposure Variability in Critically Ill Patients: A Systematic Review.Antibiotics (Basel, Switzerland) · 2024Review
- Patients with Obesity Should be Recognised as a Special Patient Population During Drug Development of Antibacterial and Antifungal Agents; A Call to Action.Clinical pharmacokinetics · 2024Article
- Curcumin and Vitamin C Attenuate Gentamicin-Induced Nephrotoxicity by Modulating Distinctive Reactive Species.Metabolites · 2022Article
- Clinical Pharmacokinetics of Gentamicin in Various Patient Populations and Consequences for Optimal Dosing for Gram-Negative Infections: An Updated Review.Clinical pharmacokinetics · 2022Review
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6 authors.
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Abstract
backgroundThe impact of weight on pharmacokinetics of gentamicin was recently elucidated for (morbidly) obese individuals with normal renal function.
objectivesTo characterize the pharmacokinetics of gentamicin in real-world obese patients, ultimately to develop dose recommendations applicable across the entire obese population.
methodsIn two large Dutch hospitals, all admitted patients with BMI ≥25 kg/m2 with at least one gentamicin administration, at least one gentamicin and at least one creatinine serum concentration measurement were included. Data from one hospital, obtained from electronic health records, combined with prospective data of non-obese and morbidly obese people with normal renal function, served as the training dataset, and data from the second hospital served as the external validation dataset.
resultsIn the training dataset [1187 observations from 542 individuals, total body weight (TBW) 52-221 kg and renal function (CKD-EPI) 5.1-141.7 mL/min/1.73 m2], TBW was identified as a covariate on distribution volume, and de-indexed CKD-EPI and ICU stay on clearance (all P < 0.001). Clearance was 3.53 L/h and decreased by 0.48 L/h with each 10 mL/min reduction in de-indexed CKD-EPI. The results were confirmed in the external validation (321 observations from 208 individuals, TBW 69-180 kg, CKD-EPI 5.3-130.0 mL/min/1.73 m2).
conclusionsBased on the study, we propose specific mg/kg dose reductions with decreasing CKD-EPI values for the obese population, and extension of the dosing interval beyond 24 h when CKD-EPI drops below 50 mL/min/1.73 m2. In ICU patients, a 25% dose reduction could be considered. These guidelines can be used to guide safe and effective dosing of gentamicin across the real-world obese population.
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