Once-daily gentamicin: translating theory into practice.
Gentamicin continues to have an important role in the treatment of serious bacterial infections. There is increasing interest in once-daily administration, which is more convenient than multiple-dose regimens. Animals studies and clinical trials suggest that once-daily administration is as efficacious and no more toxic for a variety of infections, but there is still some reluctance to use once-daily regimens routinely in neutropenic patients, because of the potential risk of breakthrough bacteraemia. A number of aspects of the serum concentration monitoring of once-daily gentamicin remain unresolved. The most commonly used assay systems are not sensitive enough, without some modification in technique, to detect the very small pre-dose concentrations seen with once-daily dosing, and it is not clear what constitutes an acceptable pre-dose concentration. Until the results from further studies become available, it is prudent to maintain a pre-dose concentration below 1 mg.1(-1), and local arrangements are necessary to address the frequency and timing of assays. It seems likely that once-daily administration will become the norm, because of its many advantages.
Cunningham
R
R
Public Health Laboratory, University Hospital, Queen's Medical Centre, Nottingham, UK.
Humphreys
H
H
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005839:Gentamicins / Q000008:administration & dosage* / Q000097:blood; D006801:Humans
D000900:Anti-Bacterial Agents; D005839:Gentamicins