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Master Thesis

Quelle est la dose de gentamicine qui permettrait d’obtenir l’objectif de pic de concentration de 30 mg/L défini par les recommandations de l’Agence Nationale de Sécurité du Médicament et des produits de santé ?

Abstract : Introduction: Previous studies have shown that with an 8 mg/kg loading dose of gentamicin, the plasma peak concentration (Cmax) objective recommended by the French National Agency for Medicines and Health Products Safety ( ANSM ) (> 30 mg/L) is rarely achieved. The aim of this study was to determine the dose of gentamicin required to achieve this Cmax of ≥ 30 mg/L. Patients and methods: We conducted a retroprospective observational cohort study in one university hospital. All consecutive patients hospitalized for severe sepsis and treated with gentamicin during a one year period were evaluated. Results: During the study period, 15 of the 57 patients (26.3%) treated with gentamicin achieved a Cmax of ≥ 30 mg/L. The median dose of gentamicin was 6.9 [5.8-9.9] mg/kg. Independent factors in the multivariate analysis associated with a Cmax of ≥ 30 mg/L were higher body mass index (per kg/m2 increment) (OR: 1.173, 95%CI: 1.015-1.356, P = 0.03) and higher loading dose of gentamicin (per mg/kg increment) (OR: 2.343, 95%CI: 1.346-4.08, P = 0.003). The best gentamicin loading dose threshold to predict a Cmax of ≥ 30 mg/L was 11 mg/kg, with a specificity and a sensitivity of 100% and 53.3% respectively. Conclusions: These results suggest that a loading dose of > 11 mg/kg is required to achieve a gentamicin Cmax of ≥ 30 mg/L in most patients (not 6 to 8 mg / kg as recommended by ANSM guidelines).
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01316818
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Tuesday, May 17, 2016 - 4:56:54 PM
Last modification on : Wednesday, August 23, 2017 - 4:40:11 PM
Long-term archiving on: : Friday, August 19, 2016 - 5:35:27 PM

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Yannick Goulamhoussen Charifou. Quelle est la dose de gentamicine qui permettrait d’obtenir l’objectif de pic de concentration de 30 mg/L défini par les recommandations de l’Agence Nationale de Sécurité du Médicament et des produits de santé ?. Médecine humaine et pathologie. 2016. ⟨dumas-01316818⟩

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