Preclinical and clinical evaluation of once-daily aminoglycoside chemotherapy.
The rationale for and effectiveness of extended dosage intervals for aminoglycosides are reviewed. Aminoglycoside antibiotics have a prolonged postantibiotic effect against a variety of common Gram-negative and Gram-positive organisms: higher serum aminoglycoside levels are associated with a longer postantibiotic effect and increased bactericidal activity. Moreover once daily aminoglycoside administration may reduce the potential for adaptive postexposure resistance by allowing less contact time between bacteria and antibiotic. A longer dosage interval may decrease the risk of nephro- and ototoxicity. At least 33 published clinical trials suggest that once-daily administration of aminoglycosides and conventional regimens involving shorter dosage intervals are equally effective in patients with normal renal function and Gram-negative infections: besides, once-daily administration may reduce the frequency of aminoglycoside toxicity or delay it.
Periti
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Department of Preclinical and Clinical Pharmacology, University of Florence, Italy.
D000617:Aminoglycosides; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015169:Colony Count, Microbial; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D006801:Humans; D066298:In Vitro Techniques; D007769:Lactams; D008826:Microbial Sensitivity Tests; D013329:Structure-Activity Relationship
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D007769:Lactams