Once versus thrice daily dose regimen of gentamicin in abdominal surgery

Abstract

Objectives: The objectives of the study are to compare the effectiveness and likelihood of toxicity of 7.5 mg/kg single high dose and 80 mg thrice daily doses of intravenous gentamicin. Material and Methods: A total of 88 patients who had abdominal surgeries on account of acute abdomen infectious etiologies in a private hospital in Lagos, Nigeria, between August 2002 and July 2004 were studied. They were randomized into two groups (A and B), with each group comprising of 44 patients. Group A had 7.5 mg single high-dose gentamicin alongside cefuroxime for 5 days. Group B had 80 mg thrice daily of gentamicin for 5 days alongside cefuroxime. Renal function tests were carried out preoperatively and postoperatively. The surgical site infection rate was compared between Groups A and B. Results: There was statistically no significant difference in effectiveness and toxicity between the two groups except for severe infections in which 7.5 mg/kg body weight single high dose gentamicin was superior to 80 mg thrice daily doses. The infection rate was similar for both groups, and the organisms isolated in both groups were resistant to gentamicin. There was no difference in renal complication rate and ototoxicity. We also found that a single high dose was more convenient for nurses to administer, cost effective, decreased personnel time and had more patient comfort. Conclusion: A single high dose of gentamicin of 7.5 mg/kg daily is comparatively effective as 80 mg thrice daily dose. The infection rate was the same in both groups, with a single high dose much better in severe infection.