Hyperbaric
oxygen exposure did not alter the pharmacokinetics of gentamicin in volunteers.
Clinical Bottom Line:
1.
No evidence of altered pharmacokinetics in healthy male volunteers with good
creatinine clearance.
Appraised
by: Mike Bennett, Dept of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Thursday, 18 March 1999
Clinical
Scenario: Healthy volunteers
Three-part
Question: Does hyperbaric oxygen alter
the pharmacokinetics of gentamicin?
Search
Terms: Gentamicin, pharmacokinetics
The
Study:
Non-blinded randomised
controlled trial with intention-to-treat.
Healthy male volunteers.
Control group (N =5;5 analysed):
Gentamicin 1.5 mg/kg IVI over 30 minutes while breathing air at 1ATA. Blood
samples taken at 0, 15, 30, 45, 60, 75, 90, 120, 180, 240 and 300 minutes for
assay.
Experimental group (N =5;5
analysed): As above , but subjects were in a monoplace hyperbaric chamber
breathing 100% oxygen at 2.4ATA. Infusion started 10 minutes into a 90-minute
oxygen breathing cycle.
The
Evidence:
Non-Event
Outcomes
Air group
HBO group
P-value
Beta
half-life (mins)
115
112
>0.78
Vd
(l/kg)
0.184
0.201
>0.26
Clearance
(l/kg/hr)
0.0676
0.0754
>0.13
Comments:
1. Randomised crossover design,
but subjects, (?observers) not blinded.
2. Single HBO exposure only does
not rule out effects from a prolonged course.
3. No information about patients
with health problems.
Expiry
date:
March 2003
References:
1. Merritt GJ, Slade JB.
Influence of hyperbaric oxygen on the pharmacokinetics of single-dose gentamicin
in healthy volunteers. Pharmacotherapy
1993;13(4):382-5.
