Once-daily dosing of aminoglycosides: review and recommendations for clinical practice.
The use of higher-dose, extended interval (i.e., once-daily) aminoglycoside regimens to optimize bacterial killing is justified by a pharmacodynamic principle of aminoglycosides, namely concentration-dependent killing, and by the partial attribution of the toxicity of aminoglycosides to prolonged serum concentrations. Numerous in-vitro and animal studies have supported using once-daily aminoglycoside dosing. Clinical studies show at least equal effectiveness and no greater toxicity when compared with traditional regimens. A dose of 5-7 mg/kg of gentamicin, tobramycin, or netilmicin, with at least a 24 h dosing interval should be employed and a similar regimen can be applied to amikacin dosing. As yet, there are some patient populations that have not been adequately studied to determine whether or not once-daily aminoglycoside dosing would be a better choice than traditional dosing regimens.
Freeman
C D
CD
Department of Medicine, University of Missouri-Kansas City School of Medicine, 64108, USA. cfreeman@cctr.umkc.edu
Nicolau
D P
DP
Belliveau
P P
PP
Nightingale
C H
CH
D000617:Aminoglycosides; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D001424:Bacterial Infections / Q000188:drug therapy*; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D006801:Humans; D017410:Practice Guidelines as Topic
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents