Aminoglycosides Impact on Survival Rate and Renal Outcomes in Patients with Urosepsis

link.springer.com April 16, 2025

The addition of aminoglycosides to beta-lactam therapy in critically ill patients with urosepsis did not significantly improve 30-day survival.

Furthermore, aminoglycosides were not associated with worse renal outcomes.

These findings may not be sufficient to challenge the current guidelines advocating the routine use of aminoglycosides in this patient population, but highlight the need for more targeted approaches to antibiotic therapy in the management of urosepsis.

Further prospective randomized trials are needed to identify subgroups of patients who may benefit from aminoglycosides.

A total of 580 patients were included, median age was 69 years (interquartile: 58–77) and 53.6% were male. Overall, 335 patients (57.8%) were in septic shock and 448 (79.2%) had AKI on admission.

A total of 579 patients (99.8%) received a beta-lactam as empirical therapy (with (n = 444) or without (n = 136) aminoglycosides).