Moore Robert H, Anele Uzoma A, Krzastek Sarah C, Klausner Adam P, Roseman J Tyler
Virginia Commonwealth University School of Medicine, 1201 E. Marshall Street, Richmond, VA 23298, USA.
Division of Urology, Virginia Commonwealth University Medical Center, West Hospital, 7th Floor, 1200 E. Broad Street, Richmond, VA 23298-0118, USA.
Case Rep Urol. 2018 Dec 4;2018:3479202. doi: 10.1155/2018/3479202. eCollection 2018.
Despite the known nephrotoxicity of gentamicin, in 2008 the American Urological Association published guidelines recommending single high-dose weight-based gentamicin prophylaxis of 5 mg/kg for procedures involving urologic prostheses. These guidelines are based on the theoretical renal safety and improved antimicrobial activity of a single large dose of gentamicin. However, the risk of nephrotoxicity after weight-based gentamicin prophylaxis specifically in penile prosthetic surgery has never been established with evidence-based studies. This is of special concern in light of the known high rates of preexisting conditions in this specific population. Therefore, in order to expose potential safety issues, we present three cases of postoperative acute kidney injury following weight-based gentamicin prophylaxis after implantation of inflatable penile prostheses.
尽管庆大霉素具有已知的肾毒性，但2008年美国泌尿外科学会发布了指南，推荐在涉及泌尿外科假体的手术中，基于体重给予单次大剂量5mg/kg的庆大霉素进行预防。这些指南基于单次大剂量庆大霉素理论上的肾脏安全性和更好的抗菌活性。然而，基于体重的庆大霉素预防后发生肾毒性的风险，尤其是在阴茎假体手术中，从未有过循证研究证实。鉴于该特定人群中已知的高并发疾病发生率，这一点尤为令人担忧。因此，为了揭示潜在的安全问题，我们呈现了3例在植入可膨胀阴茎假体后基于体重给予庆大霉素预防后发生术后急性肾损伤的病例。
