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Reactive Oxygen Metabolites and Iron in Toxic Acute Renal Failure
Published in Robin S. Goldstein, Mechanisms of Injury in Renal Disease and Toxicity, 2020
Karl A. Nath, Norishi Ueda, Patrick D. Walker, Sudhir V. Shah
Aminoglycoside antibiotics including gentamicin are widely used in the treatment of Gram-negative infections. A major complication of the use of these drugs is nephrotoxicity, accounting for 10 to 15% of all cases of acute renal failure.15 The specificity of gentamicin for renal toxicity is apparently related to its preferential accumulation in the renal proximal convoluted tubules (50 to 100 times greater than serum) and the effect of gentamicin on biological membranes appears to be critical in the pathogenetic sequence.15
Liver disease
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Antibiotics: There should be a low threshold for antibiotic therapy as AFLP carries a significant risk of sepsis. Tazocin 4.5 g IV t.d.s. (corrected for glomerular filtration rate) can be used to decolonize the gut. Gentamicin is contraindicated due to the high prevalence of AKI. Empirical anti-fungal therapy (fluconazole) should be considered with impaired intrinsic liver function.
Urolithiasis
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Thomas Johnston, James Armitage, Oliver Wiseman
Penicillin, cephalosporin and macrolide antibiotics are considered safe to use in pregnancy. Nitrofurantoin is also safe for most of pregnancy but should be avoided towards term due to an increased risk of neonatal haemolysis. Trimethoprim is a folate antagonist and should be avoided, especially in the first trimester during organogenesis. There is a risk of auditory or vestibular nerve damage with gentamicin and therefore should not be used in pregnancy. There is limited information on tazocin or carbapenems with manufactures advising to use only if the potential benefit outweighs the risk in more severe infections.
Nephroprotective effect of ferulic acid on gentamicin-induced nephrotoxicity in female rats
Published in Drug and Chemical Toxicology, 2022
Vasfiye Erseçkin, Handan Mert, Kıvanç İrak, Serkan Yildirim, Nihat Mert
Gentamicin (GM) is an aminoglycoside group antibiotic that is widely used in the treatment of Gram (-) bacteria which threaten the lives of numerous species (Ali 1995). The most prominent side effect of gentamicin is nephrotoxicity (Walker and Shah 1988, Erdem et al.2000). Nephrotoxicity symptoms occur in approximately 30% of the patients after 7 days of treatment with gentamicin (Paterson et al. 1998). Gentamicin-induced nephrotoxicity principally consists of renal inflammatory cascades, elevated renal oxidative stress, and increases in associated pathological signaling mechanisms (Balakumar et al.2010, Kandemir et al.2015), various studies have reported that antioxidant agents attenuate gentamicin-induced lipid peroxidation (Kandemir et al.2015, Yilmaz et al.2018).
Appropriateness of empirical antibiotic therapy and added value of adjunctive gentamicin in patients with septic shock: a prospective cohort study in the ICU
Published in Infectious Diseases, 2021
Rob G. H. Driessen, Rald V. M. Groven, Johan van Koll, Guy J. Oudhuis, Dirk Posthouwer, Iwan C. C. van der Horst, Dennis C. J. J. Bergmans, Ronny M. Schnabel
There are several limitations to this study. First of all, this was a single-centre study in a hospital with secondary and tertiary care, so the generalisability and extrapolation of the results can be debated. Although the results apply strongly to our centre and environment and can be different in other settings, we believe that they give valuable insights into the pathogens involved and the appropriateness of therapy in this severely ill patient group. The limited sample size of this highly selected population might influence power in this study. Moreover,there were 76 patients excluded from the analysis because there were no cultures taken (for blood cultures ranging from 3% in urogenital infections to 22% in abdominal infections) or cultures were all negative. We further analysed this finding, and the absence of blood cultures in patients with abdominal sepsis could partially be explained by the fact that more than half of these patients died within 24 h. Apparently, these patients were in end-stage septic shock, and other more urgent treatments had priority. Furthermore, confounding by indication might be reflected by the fact that the treating physician decided to administrate gentamicin, and patients receiving gentamicin tended to be more severely ill. Nevertheless, the only significant difference between the treatment groups was the vasopressor dosage, which was higher in the gentamicin group. Data on dosage and drug monitoring are not presented in the present study; however, the intended administered dosage was 7 mg/kg gentamicin in all treated patients during the study period.
Ocimum gratissimum (Linn) leaves extract attenuates oxidative stress and liver injury in gentamicin-induced hepatotoxicity in rats
Published in Egyptian Journal of Basic and Applied Sciences, 2021
Oluwadare J. Ogundipe, Omolola F. Akinpelu, Abiodun. Oyerinde, Oyelade R. Oluwakemi
One of the limitations of this study is the failure to look at the photomicrograph of the rats’ liver. This was observed at the end of this study based on the results obtained from the biochemical analyses. Though it was established that 7 days gentamicin administration caused injury to the liver based on the biochemical results, but it is not out of play if this injury can be examined structurally. Therefore, further study should be done putting in mind the structural examination. The self-healing mechanism to liver regeneration process is stimulated by the synthesis of protein [25]. The hepatic total protein level is an important index for the determination of chemically induced liver injury or dysfunction [22]. Gentamicin administration induces adverse changes in the process of protein synthesis by lowering the total protein. The extract’s ability to restore the liver total protein to its physiological levels is an indication of its tissue-regenerative ability that was least expressed in the group that received AOGL and MOGL during the cause of treatment. The MOGL treatment recovery showed restoration of liver total protein. This connote that this extract exact its physiologic action on tissue regeneration after its usage.