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. 1998 Nov;13(11):735-9.
doi: 10.1046/j.1525-1497.1998.00224.x.

Risk factors for toxicity in elderly patients given aminoglycosides once daily

D L Paterson  1 , J M Robson, M M Wagener
Affiliations

Risk factors for toxicity in elderly patients given aminoglycosides once daily

D L Paterson et al. J Gen Intern Med. 1998 Nov.

Abstract

Objective: To determine the risk factors for aminoglycoside toxicity in the elderly.

Design: Prospective observational study.

Setting: Acute care teaching hospital serving predominantly veterans.

Participants: Consecutive patients aged 70 years and over receiving aminoglycosides.

Interventions: None.

Measurements and main results: Thirteen (15%) of 88 patients developed aminoglycoside-related nephrotoxicity and 3 (3.4%) developed otovestibular toxicity. Multivariate analysis showed that increasing duration of aminoglycoside therapy was the only factor significantly associated with development of toxicity. Elevated baseline serum creatinine level (p = .02) and use of allopurinol (p = .03) were risk factors specifically for nephrotoxicity. Only 2 (3.9%) of 51 patients receiving aminoglycosides 7 or fewer days developed nephrotoxicity, as compared with 11 (30%) of 37 receiving the drugs for 8 to 14 days and 4 (50%) of 8 treated for more than 14 days.

Conclusions: Although toxicity is common in elderly patients treated with aminoglycosides, limiting the duration of aminoglycoside therapy to less than a week can substantially reduce risk of toxicity.

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Figures

Figure 1
Figure 1
Duration of the aminoglycoside course and its relation to nephrotoxicity.
Figure 2
Figure 2
Association between baseline serum creatinine level and subsequent development of nephrotoxicity.
See this image and copyright information in PMC

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