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October 1976

Decreased Gentamicin Dose

Arch Ophthalmol. 1976;94(10):1804. doi:10.1001/archopht.1976.03910040578022

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To the Editor  —.In the article, "Treatment of Post-Cataract Bacterial Endophthalmitis With Periocular and Systemic Antibiotics and Corticosteroids." (Trans Am Acad Ophthalmol Otol 81:151-162, 1976), we suggested the systemic administration of gentamicin sulfate at a dosage of "5 mg/ kg/day in three divided doses over a 24-hour period in patients with normal renal function, even though nephrotoxic and ototoxic effects may occur at this high dose level." This schedule approximates the maximal dosage for a 24-hour period and is suggested for patients with life-threatening disease.We have used this therapeutic schedule in our series of patients in combination with daily periocular injections of 40 mg of gentamicin sulfate and have encountered no untoward renal effects. However, since a periocular injection of gentamicin adds to the total systemic dose and since many patients treated for bacterial endophthalmitis are elderly and may, therefore, have a slightly decreased creatinine clearance, despite a normal

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