Once-daily aminoglycosides in the treatment of gram-positive endocarditis.
OBJECTIVE
To examine the role of once-daily aminoglycosides (ODA) in the treatment of gram-positive endocarditis.


METHODS
A MEDLINE search was conducted from January 1984 to August 1998, and a Current Contents search was performed from September 1998 to December 1998, using endocarditis or aminoglycoside as key words. In addition, relevant articles were cross-referenced to screen for additional information.


METHODS
Data published in English regarding the use of aminoglycosides in endocarditis are cited. Emphasis was placed on animal and human studies, but in vitro studies and review articles are also included.


RESULTS
Endocarditis and the pharmacology of aminoglycosides are briefly reviewed. ODA is an alternative to conventional dosing in the treatment of endocarditis. Extensive work in endocarditis has been done recently in animals and humans to add to our understanding. Limited clinical data exist to support the theoretical advantages of increased efficacy, reduced toxicity, and potential cost savings versus traditional synergistic aminoglycoside dosing. Optimal monitoring of ODA remains undefined.


CONCLUSIONS
Routine use of ODA for the treatment of endocarditis is not yet advocated. Promising supporting evidence and speculation of success of ODA in gram-positive endocarditis justify well-designed trials to further define its role in therapy.
Tam
V H
VH
Albany College of Pharmacy, NY 12208, USA.
Preston
S L
SL
Briceland
L L
LL
D000617:Aminoglycosides / Q000008:administration & dosage*; D000818:Animals; D002986:Clinical Trials as Topic; D003625:Data Collection; D004334:Drug Administration Schedule; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D066298:In Vitro Techniques
D000617:Aminoglycosides