Elimination of tritiated gentamicin in normal human subjects and in patients with severely impaired renal function

Abstract

The excretion of gentamicin, a widely used broad‐spectrum antibiotic complex, is reduced in renal failure. In order to prevent the cumulation of the drug to toxic serum concentrations, several investigators have produced nomograms relating gentamicin dosage to the level of renal function. Evidence is presented that the one‐component kinetic model upon which these nomograms are based is inadequate to describe the disposition of gentamicin. Pharmacokinetic considerations indicate that usage of such nomograms in patients with moderately reduced or normal renal function may lead to inadequate serum concentrations of the drug. In addition, evidence is presented that a certain amount of intravenously administered gentamiCin is excreted as a coniugated metabolite.