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August 16, 1976

Management of Bacterial Shock-Reply

Author Affiliations

University of Southern California School of Medicine Los Angeles

JAMA. 1976;236(7):820. doi:10.1001/jama.1976.03270080011005

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In Reply.—  Dr Minuth refers to alternative methods for estimating doses of gentamicin based on measurements of serum levels of the aminoglycoside. Serum levels do, in fact, represent an entirely reasonable basis for estimating doses. However, in the anecdote of a personal case that he cites in support of his argument, no data of this type are supplied.With reference to recommendations made by my late colleague, Dr Shubin, and me, we anticipated that serum creatinine would be measured on a daily basis and that intervals between doses would be adjusted accordingly. If there were substantial improvement in creatinine clearance and a corresponding reduction in serum creatinine, the interval between doses would be shortened and the total amount of gentamicin administered would be correspondingly increased.