394 Gentamicin Guidelines – Available but Are They Followed? a Retrospective Audit

Abstract

Abstract Introduction Many hospitals include gentamicin as part of prescribing protocols for clinical situations such as bacterial septicemia and urinary tract infections. High doses of gentamicin can lead to nephrotoxicity and/or auditory dysfunction. To prevent this, most hospital guidelines advise to adjust dosing according to age, renal function and if the patient is overweight. With therefore quite a complex prescribing protocol, an audit of the prescribing practices at the trust was deemed necessary to determine if clinical protocol was being followed for inpatient gentamicin dosing. Method A retrospective audit of all patients prescribed gentamicin as an inpatient between 1st of August and 31st of October 2020 was performed. Data was collected from two separate electronic record systems and combined. Results 2224 doses of Gentamicin (to 1224 patients) were given in the study period. Gentamicin dosing was not adjusted for obesity in either the <70 or >70 age group (p<0.05 for both). Dosing was not adjusted for Creatine clearance (p<0.05). 86% of patients that needed a gentamicin level had one taken but 15% had it taken too early. Of those who had a Gentamicin level >1, 100% had their next dose held. Conclusions Although gentamicin levels are taken and acted on effectively in most cases, a large proportion of patients are not being dosed as per protocol and therefore at risk of the side effects of overdosing or being clinically under treated. With such a complex prescribing protocol, electronic tools need to be implemented to improve compliance across the trust.