Adequacy of a hospital-wide standard dose of 7mg/kg bodyweight gentamicin sufficient to achieve an adequate prophylactic maximum serum concentration (Cmax) in burn patients undergoing surgical burn wound treatment.

Abstract Introduction Pharmacokinetics of drugs can be significantly altered in burn patients. The aim of our study was to validate if the current hospital-wide standard dosage of 7 mg/kg total bodyweight gentamicin is sufficient to achieve an adequate prophylactic C max ( C max  ≥ 20 mg/L). Materials and methods A prospective observational cohort pharmacokinetic study was conducted in burn patients undergoing surgical burn wound treatment. Results 36/40 (90%) burn patients undergoing surgical burn wound treatment at Rotterdam Burn Centre (Maasstad Hospital), the Netherlands, achieved adequate prophylactic serum concentrations ( C max  ≥ 20 mg/L) after a single prophylactic intravenous dose of 7 mg/kg total bodyweight gentamicin. Total Body Surface Area (TBSA) burned and total bodyweight were statistically significantly correlated with the C max , with correlation coefficients of −0.316, 0.443 and p values of 0.047, 0.004, respectively. Other covariates (age, time after injury, serum creatinine, dose, gender, intensive care admittance) were not statistically significantly correlated. Occurrence of postoperative infection was limited ( n  = 1), no statistically significant difference was observed between patients with a therapeutic and patients with a subtherapeutic serum concentration. Conclusion The current hospital-wide standard dosage of 7 mg/kg total bodyweight is sufficient to achieve an adequate prophylactic C max in burn patients undergoing surgical burn wound treatment.