Aminoglycoside dosing considerations in intensive care unit patients.
OBJECTIVE
Factors affecting aminoglycoside dosing requirements in critically ill adult patients were reviewed.


METHODS
A literature search was performed from 1979 to 1992 and articles pertaining to aminoglycoside dosing were obtained.


METHODS
Only studies appearing in peer-reviewed journals were selected. Topics selected included: bactericidal kill kinetics, once-daily dosing regimens, critical illness, toxicity, aminoglycosides, intensive care unit, and lung penetration.


CONCLUSIONS
Studies suggest that larger initial aminoglycoside doses are necessary in critically ill patients (tobramycin/gentamicin 3 mg/kg or amikacin 9 mg/kg) to achieve adequate peak serum concentrations. Current studies have not shown an increase in the incidence of aminoglycoside toxicity when using these larger initial doses. Follow-up monitoring is dependent upon the patient's physiology and risk factors for aminoglycoside-induced toxicity.
Watling
S M
SM
Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, PA.
Dasta
J F
JF
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D003422:Critical Care / Q000379:methods*; D004311:Double-Blind Method; D006801:Humans; D007362:Intensive Care Units; D008657:Metabolic Clearance Rate; D008991:Monitoring, Physiologic; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents