Challenging conventional aminoglycoside dosing regimens. The value of experimental models.
Although newer antimicrobials look promising for the treatment of serious gram-negative infections, aminoglycosides still remain part of the mainstay of their therapy. Traditional intermittent therapy is based upon the premise that high serum aminoglycoside concentrations are toxic. However, the rate of bacterial killing for aminoglycosides is also a concentration-dependent phenomenon. Two animal models of Pseudomonas pneumonia were utilized to examine the efficacy of non-traditional aminoglycoside dosing regimens, i.e., single, high daily doses versus the conventional, intermittent low doses of aminoglycosides. Other recent data suggest that toxicity might also be less with the large, single daily dose regimen. The current dosing strategy used for aminoglycosides may not be maximizing their therapeutic potential, nor minimizing their toxicities.
D000617:Aminoglycosides / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D006168:Guinea Pigs; D011014:Pneumonia / Q000188:drug therapy*; D011552:Pseudomonas Infections / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D011897:Random Allocation; D014031:Tobramycin / Q000008:administration & dosage* / Q000627:therapeutic use
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D014031:Tobramycin