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.