{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T18:58:11Z","timestamp":1754161091615,"version":"3.41.2"},"reference-count":13,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dan Med J"],"abstract":"<jats:p>INTRODUCTION. Hesitancy towards the use of aminoglycosides persists among clinicians due to the perceived risk of nephrotoxicity.\n\nMETHODS. This retrospective cohort study included adults with community-acquired bacteraemia and no pre-existing renal failure. The patients were divided into two groups matched 1:1 by age (\u00b1 5 years): 1) patients treated with short-term (\u2264 3 days) once-daily gentamicin within 24 hours of admission and 2) non-gentamicin-treated patients. The primary endpoint was an increase in plasma creatinine levels of \u2265 40 \u00b5mol\/l from baseline. Cause-specific Cox regression was used to compute hazard ratios (HR) with 95% confidence intervals (CI) for prognostic factors of acute kidney injury (AKI) and death.\n\nRESULTS. A total of 310 adults with bacteraemia were included, among whom 159 (49%) were treated with gentamicin and 151 (51%) with other antibiotics. No significant between-group differences were observed in sex distribution, comorbidities, biochemical variables and vital signs at admission. In the gentamicin-exposed group, 11 (7%) patients developed AKI compared with 12 (8%) patients in the non-exposed group. Gentamicin was neither associated with increased risk of AKI (HR = 0.86; 95% CI: 0.38-1.96) nor with 30-day mortality (HR = 0.73; 95% CI: 0.38-1.41) compared with other antibiotic regimens.\n\nCONCLUSIONS. Our study showed no increase in the risk of developing AKI and no increase in all-cause mortality in patients treated with short-term once-daily gentamicin for community-acquired bacteraemia compared with other antibiotic regimens.\n\nFUNDING. None.\n\nTRIAL REGISTRATION. Not relevant.<\/jats:p>","DOI":"10.61409\/a08240568","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T02:58:19Z","timestamp":1740711499000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Nephrotoxicity associated with short-term gentamicin therapy in community-acquired bacteraemia: risk of nephrotoxicity"],"prefix":"10.61409","author":[{"given":"Oliver Wagner Ulf","family":"Nielsen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikkel Oliver Skov","family":"Risum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans Linde","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Bodilsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"40208","published-online":{"date-parts":[[2025,3,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Paul M, Shani V, Muchtar E et al. Systematic review and meta-analysis of the efficacy of appropriate empiric antibiotic therapy for sepsis. Antimicrob Agents Chemother. 2010;54(11):4851-63. https:\/\/doi.org\/10.1128\/AAC.00627-10","DOI":"10.1128\/AAC.00627-10"},{"key":"ref1","unstructured":"DSI. DSI guidelines. www.infmed.dk\/guidelines. (4 Jun 2024)"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):c179-c184. https:\/\/doi.org\/10.1159\/000339789","DOI":"10.1159\/000339789"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Lindvig KP, Nielsen SL, Henriksen DP et al. Mortality and prognostic factors of patients who have blood cultures performed in the emergency department: a cohort study. Eur J Emerg Med. 2016;23(3):166-72. https:\/\/doi.org\/10.1097\/MEJ.0000000000000250","DOI":"10.1097\/MEJ.0000000000000250"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Carlsen S, Boel J, Jarl\u00f8v JO et al. The effect of short-course gentamicin therapy on kidney function in patients with bacteraemia - a retrospective cohort study. Eur J Clin Microbiol Infect Dis. 2018;37(12):2307-12. https:\/\/doi.org\/10.1007\/s10096-018-3376-6","DOI":"10.1007\/s10096-018-3376-6"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Prytz KL, Prag M, Fredlund H et al. Antibiotic treatment with one single dose of gentamicin at admittance in addition to a b-lactam antibiotic in the treatment of community-acquired bloodstream infection with sepsis. PLoS One. 2020;15(7):e0236864. https:\/\/doi.org\/10.1371\/journal.pone.0236864","DOI":"10.1371\/journal.pone.0236864"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Cobussen M, Haeseker M, Stoffers J et al. Renal safety of a single dose of gentamicin in patients with sepsis in the emergency department. Clin Microbiol Infect. 2021;27(5):717-23. https:\/\/doi.org\/10.1016\/j.cmi.2020.06.030","DOI":"10.1016\/j.cmi.2020.06.030"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Freundlich M, Thomsen RW, Pedersen L et al. Aminoglycoside treatment and mortality after bacteraemia in patients given appropriate empirical therapy: a Danish hospital-based cohort study. J Antimicrob Chemother. 2007;60(5):1115-23. https:\/\/doi.org\/10.1093\/jac\/dkm354","DOI":"10.1093\/jac\/dkm354"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Spanggaard MH, H\u00f8nge BL, Sch\u00f8nheyder HC, Nielsen H. Short-term gentamicin therapy and risk of renal toxicity in patients with bacteraemia. Scand J Infect Dis. 2011;43(11-12):953-6. https:\/\/doi.org\/10.3109\/00365548.2011.601755","DOI":"10.3109\/00365548.2011.601755"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Lopez-Novoa JM, Quiros Y, Vicente L et al. New insights into the mechanism of aminoglycoside nephrotoxicity: an integrative point of view. Kid Int. 2011;79(1):33-45. https:\/\/doi.org\/10.1038\/ki.2010.337","DOI":"10.1038\/ki.2010.337"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Hayward RS, Harding J, Molloy R et al. Adverse effects of a single dose of gentamicin in adults: a systematic review. Br J Clin Pharmacol. 2018;84(2):223-38. https:\/\/doi.org\/10.1111\/bcp.13439","DOI":"10.1111\/bcp.13439"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Ong DSY, Frencken JF, Klouwenber PMCK et al. Short-course adjunctive gentamicin as empirical therapy in patients with severe sepsis and septic shock: a prospective observational cohort study. Clin Infect Dis. 2017;64(12):1731-6. https:\/\/doi.org\/10.1093\/cid\/cix186","DOI":"10.1093\/cid\/cix186"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Boyer A, Gruson D, Bouchet S et al. Aminoglycosides in septic shock: an overview, with specific consideration given to their nephrotoxic risk. Drug Saf. 2013;36(4):217-30. https:\/\/doi.org\/10.1007\/s40264-013-0031-0","DOI":"10.1007\/s40264-013-0031-0"}],"container-title":["Danish Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T13:57:42Z","timestamp":1753711062000},"score":1,"resource":{"primary":{"URL":"https:\/\/ugeskriftet.dk\/dmj\/A08240568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,1]]},"references-count":13,"URL":"https:\/\/doi.org\/10.61409\/a08240568","relation":{},"ISSN":["2245-1919"],"issn-type":[{"type":"electronic","value":"2245-1919"}],"subject":[],"published":{"date-parts":[[2025,3,1]]}}}