[Skip to Content]
[Skip to Content Landing]
August 16, 1976

Management of Bacterial Shock

Author Affiliations

Modesto, Calif

JAMA. 1976;236(7):819-820. doi:10.1001/jama.1976.03270080011004

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


To the Editor.—  Gentamicin sulfate administered to patients with renal failure at intervals between doses as recommended by Shubin and Weil (235:421, 1976) leads to serum levels below 1μg/ml (Ann Intern Med 74:192, 1971), which could persist for long periods if renal function improves before the next dose. We recently treated such a patient with traumatic bowel perforation and a creatinine level of 7.5 mg/100 ml with a maintenance dose of 30 mg every eight hours the first day. This was increased to 50 mg by the fourth day because the creatinine level had decreased to 5.1 mg/100 ml. Using the schedule shown by Shubin and Weil, the patient would not have received gentamicin for four full days after his initial loading dose. I believe Chan's nomogram for giving a reduced dose of gentamicin every eight hours (Ann Intern Med 76:773, 1972) allows for better control of serious infection by