Use of the combination of beta-lactams and aminoglycosides in critic patients. Intensive Care Unit - Hospital de Clínicas (August-September 2022)

Abstract

The present study sought to characterize the use of the combination of beta-lactams and parenteral
aminoglycosides, as well as the occurrence of adverse effects in patients admitted to the ICU of the
Hospital de Clínicas "Dr. Manuel Quintela" during the period August-September 2022.
Individuals receiving the combination of interest during their stay were included. The diagnosis that
motivated its use and its clinical characteristics were recorded.
To develop the study, the variation of parameters of interest was quantified daily.
In the 12 individuals included, the most frequently used combination was cefuroxime-gentamicin (n=9) in
individuals indicated for cardiac surgery prophylaxis.
The antibiotic combinations administered in all cases followed the current recommendations of the MSP
and the institutional PROA. However, in 44.4% of the cases of cardiac surgery prophylaxis, the duration of
treatment was 72 hours, whereas the recommended duration was 48 hours. The doses of gentamicin used
were not adjusted to the patients, with 240 mg being administered in all the individuals who received it
(n=10).
The effectiveness of the treatments couldn’t be properly evaluated due to the lack of data on acute phase
reactants. No adverse effects exclusively attributable to the antibiotics evaluated were found, only the
development of acute renal injury was observed in 1 individual.
It would be appropriate in future studies to extend the time of data collection to evaluate in detail the use
of the combination and follow the included individuals beyond their stay in the CTI, thus objectifying the
subsequent appearance of adverse effects.