National survey of extended-interval aminoglycoside dosing.
A random sample survey of 500 acute care hospitals in the United States was conducted to evaluate the adoption of extended-interval aminoglycoside dosing (EIAD). The survey revealed that EIAD has been adopted in 3 of every 4 acute care hospitals, a 4-fold increase since 1993. Of the 74.7% of hospitals reporting EIAD, 64% had written guidelines. Equal or less toxicity (87.1%), equal efficacy (76.9%), and cost-savings (65.6%) were common rationales. There has been a trend toward higher adult dosages of gentamicin (e.g., >5 mg/kg/dose) and an increase in the adoption of EIAD across all age groups (neonatal, 11%, and pediatric, 23%). Monitoring of aminoglycoside concentrations has shifted to a single determination of concentration, at 6-18 h after drug administration. The most common methods of dosage adjustment for declining renal function were an interval extension with the same dose (47%) or use of the Hartford nomogram (32%).
Chuck
S K
SK
College of Pharmacy, Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL 60612, USA.
Raber
S R
SR
Rodvold
K A
KA
Areff
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D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D019538:Health Care Surveys; D006761:Hospitals; D006801:Humans; D007223:Infant; D007239:Infections / Q000188:drug therapy*; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014481:United States
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents