Prevalence of abnormal aminoglycoside trough levels in children with clinically suspected gram negative infections at a tertiary level hospital In Kenya - a cross sectional study

Abstract

Background: Aminoglycosides are used to treat severe gram-negative infections. The associated risk of nephro toxicity necessitates therapeutic drug level monitoring.

Objectives: This study attempted to determine prevalence of abnormal aminoglycoside trough levels in children below the age of 12 years and to determine if glomerular filtration rate (GFR) estimation using Schwartz formula correlates with drug trough levels.

Materials and Methods: This was a cross sectional study enrolling children aged one day to 12 years on aminoglycosides, at a private tertiary facility in Nairobi. Aminoglycoside drug trough levels and serum creatinine measurements were analyzed for a calculated sample size of 81 patients. GFR was estimated using Schwartz formula. The Pearson correlation coefficient was calculated between the drug trough levels and estimated GFR.

Results: Median age of participants was 3 days (IQR 19). The prevalence of abnormal aminoglycoside trough levels was 4.9% (95% CI 1.4% to 12.2%). The Pearson correlation coefficient between aminoglycoside trough levels and GFR was -0.342. The area under the receiver operating characteristic (ROC) curve was 0.6185

Conclusion: The prevalence of abnormal aminoglycoside trough levels was low and therefore the routine screening of patients on aminoglycoside therapy for toxicity using drug trough levels may not be justified.