Prevalence and predictors of sub-optimal serum gentamicin levels in sickle cell disease patients undergoing Hartford protocol
العناوين الأخرى
شيوع و مؤشرات المستوى دون الأمثل للجنتامايسين في دم مرضى الأنيميا المنجلية الخاضعين للعلاج حسب بروتوكول هارتفورد
مقدم أطروحة جامعية
Abu Sham, Ahmad Abd al-Rahim Ali
مشرف أطروحة جامعية
al-Zakwani, Ibrahim S.
al-Kindi, Salam M. Z.
Muhammad, Abd al-Wahhab Hasan
الجامعة
جامعة أم درمان الإسلامية
الكلية
كلية الصيدلة
القسم الأكاديمي
قسم الصيدلة السريرية
دولة الجامعة
السودان
الدرجة العلمية
دكتوراه
تاريخ الدرجة العلمية
2009
الملخص الإنجليزي
This was a retrospective study analysis conducted in a university teaching hospital over a 3.5-year period from January 2005 to May 2008.
Four-hundred and seven serum gentamicin level (SGL) episodes representing 248 patients were evaluated.
The overall mean age of the study cohort was 23±5 with males representing 54 % (n = 219) of the subjects.
Three hundred and thirty nine (83 %) of the 407 episodes, were considered suboptimal levels (< 1 mcg / ml).
Multivariate analysis using logistic regression revealed increasing odds of having suboptimal SGL 8-hour post gentamicin infusion with younger age and higher creatinine clearance.
Patients who are 23 years or younger are 2-fold more likely to have suboptimal SGL compared with those who are above 23 years of age (95 % CI : 1.1-3.3; p = 0.026).
Patients with creatinine clearance of 200 ml/min and above are 3.8 times more likely to have suboptimal SGL compared to those with creatinine clearance less than 200 ml/min (95 % CI : 1.9-7.4 ; p < 0.001).
Furthermore, the logistic regression model demonstrated that with each one unit increase in serum urea, patients were 20 percent less likely to have suboptimal SGL (95 % CI : 0.73 -0.97 ; p = 0.017) and that patients who are on piperacillin±tazobactam therapy given concurrently with gentamicin, are 50 percent less likely to have suboptimal SGL (95 % CI : 0.6-0.81 ; p = 0.007).
This study has demonstrated that the majority of SCD patients undergoing Hartford protocol had suboptimal SGL 8-hour after drug administration.
Suboptimal levels appeared to be significantly related to young age and rapid clearance of drug.
The resulting 16 hours spent below the MIC of micro-organisms may represent a potential for therapeutic failure.
We recommend that the existing Hartford monogram should be modified to fit SCD patients’ population depending on clinical outcome; otherwise clinicians may revert to traditional gentamicin therapy.
التخصصات الرئيسية
الموضوعات
عدد الصفحات
68
قائمة المحتويات
Table of contents.
Abstract.
Chapter One : Introduction.
Chapter Two : Literature review.
Chapter Three : Materials and methods.
Chapter Four : Results.
Chapter Five : Discussion.
References.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Abu Sham, Ahmad Abd al-Rahim Ali. (2009). Prevalence and predictors of sub-optimal serum gentamicin levels in sickle cell disease patients undergoing Hartford protocol. (Doctoral dissertations Theses and Dissertations Master). Omdurman Islamic University, Sudan
https://search.emarefa.net/detail/BIM-366171
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Abu Sham, Ahmad Abd al-Rahim Ali. Prevalence and predictors of sub-optimal serum gentamicin levels in sickle cell disease patients undergoing Hartford protocol. (Doctoral dissertations Theses and Dissertations Master). Omdurman Islamic University. (2009).
https://search.emarefa.net/detail/BIM-366171
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Abu Sham, Ahmad Abd al-Rahim Ali. (2009). Prevalence and predictors of sub-optimal serum gentamicin levels in sickle cell disease patients undergoing Hartford protocol. (Doctoral dissertations Theses and Dissertations Master). Omdurman Islamic University, Sudan
https://search.emarefa.net/detail/BIM-366171
لغة النص
الإنجليزية
نوع البيانات
رسائل جامعية
رقم السجل
BIM-366171
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر