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Journal of Parenteral and Enteral Nutrition
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Clinical Trial

The In Vivo Availability of Gentamicin When Admixed with Total Nutrient Solutions: A Comparative Study

Jack W. Kern, PHARM.D.

School of Pharmacy of the University of Southern California

Kum Ja Lee, PHARM.D.

School of Pharmacy of the University of Southern California

James T. Martinoff, PH.D., M.D.

School of Pharmacy of the University of Southern California

Howard Silberman, M.D.

Department of Surgery of the University of Southern California School of Medicine, and the Los Angeles County- University of Southern California Medical Center, Los Angeles, California

The relative in vivo availability of gentamicin when administered by two different intravenous methods was evaluated in patients treated in a surgical intensive care unit in a randomized, prospective, crossover study. Each patient received gentamicin therapy via intravenous piggyback (IVPB) and in-line burette (ILB) methods. In the IVPB method, the drug was mixed in 5% dextrose in water (D5W) and infused intermittently. In the ILB method, the drug was mixed using the patient's total nutrient admixture (TNA) solution as the diluent in an ILB, which was inserted between the TNA bottle and its administration set and infused intermittently. A serial sampling of four sets of serum concentrations of the gentamicin was obtained. Pharmacokinetic parameters (Kel, Vd, and a maximum serum concentration) were calculated from the four sets of concentrations collected per patient. The IVPB method yielded mean values of Kel, Vd, and C15mg/kg of 0.13 hr-1, 0.39 liter/kg, and 5.1 µg/ml, respectively. The ILB method yielded mean values of Kel, Vd, and C1.5mg/kg of 0.14 hr -1, 0.34 liter/kg, and 5.6 µg/ml, respectively. A t-test for paired samples was applied to these mean values. Significant difference was not found (p > 0.05). The intermittent infusion of gentamicin, using TNA as the diluent and an ILB, produced equivalent serum concentrations when compared with D5W as the diluent. (Journal of Parenteral and Enteral Nutrition 14:523-526, 1990)

Journal of Parenteral and Enteral Nutrition, Vol. 14, No. 5, 523-526 (1990)
DOI: 10.1177/0148607190014005523
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