Cancer patient aminoglycosides

Haas A, Anderson L, Lad T. The influence of aminoglycosides on the nephrotoxicity of cis-diamminedichloroplatinum in cancer patients J Infect Dis I983 I47(2) 363. 

Cimino MA, Rotstein CR, Slaughter RL, Emrich LJ, Relationship of serum antibiotic concentrations to nephrotoxicity in cancer patients receiving concurrent aminoglycoside and vancomycin therapy, Am J Med, 1987,83 1091-97. 

Infections are a frequent cause of morbidity in the immunocompromised cancer patients and often necessitate antibiotic therapy. The use of certain bread-spectrum antibiotics, which are potentially nephrotoxic by themselves, may add to the renal toxicity of the anticancer agents. Clinically, the incidence of nephrotoxicity has heen recognized to be greater in patients receiving cisplatin in combination with aminoglycosides than in patients receiving cisplatin alone [46]. 

Major risk factors for renal toxicity in cancer patients include nephrotoxic chemotherapy drugs, age, nutritional status, concurrent use of other nephrotoxic drugs (e.g., aminoglycoside antibiotics), and preexisting renal dysfunction. Drugs with a high risk for renal toxicity include cisplatin, ifosfamide,... 

Paul M, Soares-Weiser K, Grozinsky S, Leibovici L. Beta-lactam versus beta-lactam-aminoglycoside combination therapy in cancer patients with neutropaenia. Cochrane Database Syst Rev 2003 3 CD003038. 

The nephrotoxicity of various combinations of antibiotics was assessed in 171 cancer patients (139 treated with a combination of aminoglycoside with penicillin or cephalosporin 32 treated with amphotericin B or vancomycin with other antibacterials). The highest nephrotoxicity (based on changes in urea and electrolytes) was found in patients treated with amphotericin B with an aminoglycoside and a cephalosporin. ... 

The nephrotoxicity of various combinations of antibiotics was assessed in 171 cancer palienls. In Ihose receiving an aminoglycoside with a third generation cephalosporin, the most nephrotoxic combinations were found to be gentamicin with cefotaxime (although another study did not find this combination to be nephrotoxic ) and amikacin with ceftriaxone, where 5 of 20 and 5 of 13 patients, respectively, had increased serum creatinine. The following combinations were found to be safer amikacin with cefoxitin or ceftazidime, gentamicin with cefoxitin, and netilmicin with cefotaxime. ... 

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