Tel.: 972-599225906, 972-2940475 Running Title: Gentamicin and Amikacin Comparative Nephrotoxicity 2 A Prospective Comparative Study of Gentamicin and Amikacin Induced Nephrotoxicity in Patients with Normal Baseline Renal Function Abstract Aim: The aim of this study was to compare the nephrotoxic potential of amikacin (AK) and gentamicin (GM) in patients with normal baseline renal function. Methodology: A one-year, non-interventional prospective study of patients administered either GM or AK. The study was carried out at the internal department of Al-Watani governmental study. Nephrotoxicity was defined as a serum creatinine (Cr) increase of ≥ 0.5 mg/ dL from the basal (normal) Cr level. Results: The two groups (GM, n = 45 and AK, n = 49) were similar in population composition, underlying pathology and infectious process requiring antimicrobials. No significant difference in age was found between patients in the GM and AK groups, P = 0.83. Patients in the GM group received comparatively lower dose than those in the AK group (mean = 2.5 mg/kg/d and 14.4 mg/kg/d respectively) but duration of treatment was similar. Sixteen of 45 patients receiving GM (35.6%) and 8 of 49 receiving AK (16.3%) developed nephrotoxicity, P = 0.033. Single daily dosing with gentamicin, regardless of the total daily dose, produced less nephrotoxicity than multiple dosing. In contrast, amikacin given at a total dose of 1 gr daily, showed no benefit of single dosing compared to multiple dosing. Conclusion: In patients with initial normal renal function gentamicin was significantly more nephrotoxic than amikacin. Multiple dosing of gentamicin was more nephrotoxic than single dosing. Amikacin induced nephrotoxicity was not significantly dependent on dosing frequency.
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