Frequency and Demographics of Gentamicin Use.

OBJECTIVE

To understand how aminoglycosides such as gentamicin are used in a tertiary care setting. To familiarize otologists with the demographics and risk factors associated with gentamicin use at major medical centers to allow the possibility of early intervention.

STUDY DESIGN

Retrospective review of existing clinical data.

SETTING

University of Rochester Medical Center (URMC), including all associated hospitals (Strong Memorial Hospital, Highland Hospital, etc.).

PATIENTS

All hospital inpatients who were prescribed intravenous gentamicin over a 4-year period starting in February 2011.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Major patient populations receiving gentamicin and the associated diagnoses for which gentamicin was prescribed.

RESULTS

A total of 5,257 patients were found to have received gentamicin. Three major populations of patients were found to have received gentamicin: 1) more than half the gentamicin exposures were children and 42% were under 2 years. 2) 18% of the exposures were young adults age 18 to 34 and in this population 88% were woman with most of these hospitalizations pregnancy related. 3) Patients >55 were 19% of the exposures and most of these had serious infections. Disorders associated with patients receiving gentamicin included: perinatal complications (1,564); sepsis (1,399); acute/chronic renal disease (1,287); labor, delivery, or neonatal complications (1,250); diabetes (949); and UTI/pyelonephritis (775).

CONCLUSIONS

Gentamicin is still widely used, and the neonatal population and young adult women are at especially high risk for gentamicin-induced ototoxicity. Further data analysis should focus strategies to protect these populations by avoiding unnecessary exposures and by possible concurrent administration of protective medications such as metformin and aspirin.