Aminoglycoside dosing in diabetes.
Studies have evaluated the comparative efficacy, toxicity and costs associated with extended-interval vs. standard multiple daily dosing of aminoglycosides. In this case, an elderly man with diabetes and good renal function at baseline was switched from standard to extended-interval dosing. During the course of therapy there was evidence of decreased renal function. Pertinent literature was searched for, uncovered and critically evaluated to determine if and what evidence supports using extended dosing of aminoglycosides in this population. No data were found specifically evaluating the different dosing strategies in diabetic patients. However, there were many trials and several meta-analysis located that compared the two dosing strategies, most suggesting at least a cost advantage and possibly less toxicity with extended-interval dosing. Further information is needed to determine whether there is a differential risk for toxicity between these dosing regimens in patient with diabetes.
Axworthy
S
S
College of Pharmacy, Dalhousie University, 5968 College Street, Halifax, Nova Scotia, Canada B3H 3J5.
Gardner
D
D
D000368:Aged; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology; D003362:Cost-Benefit Analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004334:Drug Administration Schedule; D019317:Evidence-Based Medicine; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008297:Male; D015201:Meta-Analysis as Topic; D016896:Treatment Outcome
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents