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James E. Pennington, David C. Dale, Herbert Y. Reynolds, James D. MacLowry, Gentamicin Sulfate Pharmacokinetics: Lower Levels of Gentamicin in Blood during Fever, The Journal of Infectious Diseases, Volume 132, Issue 3, September 1975, Pages 270–275, https://doi.org/10.1093/infdis/132.3.270
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Abstract
The effect of fever on serum concentrations and urinary excretion of gentamicin sulfate was studied in humans and dogs. Endotoxin-induced fever in dogs resulted in a decrease of approximately 25% in levels of gentamicin in serum 30 and 60 min after intravenous injection of the antibiotic (1.5 mg/kg) when compared with corresponding afebrile values. In six volunteers with etiocholanolone-stimulated fever, serum concentrations of gentamicin were reduced by an average of 40% in all measurements made 1, 2, and 3 hr after intramuscular injection (1.5 mg/kg) as compared with afebrile control values in the same subject. Fever was thought to be the principal factor associated with lower levels of gentamicin, although the half-life of gentamicin in serum and renal clearance of the antibiotic were not significantly affected. These findings emphasize the need for frequent measurements of gentamicin in serum as a guide to adjustment of gentamicin treatment in febrile subjects, and perhaps in all patients receiving the antibiotic.