Masters Degrees (DP) Pharmacy

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    Monitoring of gentamicin concentrations in obstetrics and gynaecology patients at Windhoek Central Hospital and Katutura Intermediate Referral Hospital
    (University of Namibia, 2018) Singu, Bonifasius Siyaka
    The aim of this study was to assess whether the gentamicin dosing strategy as presently performed at Katutura Intermediate Referral Hospital and Windhoek Central Hospital produces gentamicin serum concentrations that are within the recommended therapeutic ranges. This was a quantitative, prospective and observational/non-interventional study. Patients (n=35) Patients who were admitted and receiving gentamicin therapy in the obstetrics & gynaecology wards of the two hospitals (Katutura Intermediate Referral Hospital and Windhoek Central Hospital) were recruited and two blood samples taken from each patient. The first sample was drawn at 1 hour after starting the infusion and a second sample after 6 hours. Serum gentamicin and serum creatinine concentrations were determined using a Thermo Scientific Indiko Plus® autoanalyser and plots of serum gentamicin concentration vs time on semi-logarithmic paper were used to deduce the pharmacokinetic characteristics. Data were analyzed using descriptive statistics. The study revealed that 80.0% of non-PID patients received doses that were lower than the 5-7 mg/kg recommended for once daily dosing. In addition, 86.3% of patients had Cmax values that were below the recommended 17-25 μg/mL. All patients treated against PID had their doses falling within the recommended 3-5 mg/kg, but no guiding literature was found to act as a reference for the serum gentamicin levels in PID patients. The results from this study led to the following recommendations: i) discontinue the use of standard dosing of gentamicin, ii) use mg/kg dosing method in determining gentamicin doses, iii) monitor the gentamicin levels to ensure safety and efficacy, iv) studies to evaluate the antimicrobial effectiveness of the 3-5 mg/kg PID dose should be carried out.