title: Guidelines for aminoglycoside use and applicability to geriatric patients.
abstract: OBJECTIVE
  The authors had for objective to evaluate the applicability of AFSSAPS guidelines for aminoglycoside use to geriatric patients.
  
  
  METHODS
  Theoretical doses and dosing regimens allowing reaching target concentrations in this population were calculated by applying a pharmacokinetic model to 30 geriatric patients treated by amikacin.
  
  
  RESULTS
  The dose allowing reaching a maximum concentration of 60 mg/L was 1.217 mg on average. The time required to reach a blood concentration lower than or equal to 2.5mg/L was 62.5±70.4 hours. Forty-six percent of patients had a trough concentration greater than 2.5 mg/L, 48 hours after administration. For these patients, the time between critical minimum inhibitory concentration (MIC) and toxicity threshold concentration was 21.9±14.9 hours.
  
  
  CONCLUSIONS
  Reaching a target concentration can be problematic in geriatric patients. It is frequently necessary to use dosing intervals greater than 48 hours. The effectiveness and safety of these regimens remain uncertain.
authors.affiliation: Hospices Civils de Lyon, Groupement Hospitalier de Gériatrie, Service Pharmaceutique, Hôpital Antoine-Charial, 40 Avenue de la Table-de-Pierre, 69340 Francheville, France. mathieu.uhart@chu-lyon.fr
authors.forename: M
authors.initials: M
authors.lastname: Uhart
authors.forename: B
authors.initials: B
authors.lastname: Leroy
authors.forename: P
authors.initials: P
authors.lastname: Maire
authors.forename: L
authors.initials: L
authors.lastname: Bourguignon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism*; D000583:Amikacin / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001499:Bayes Theorem; D003257:Consumer Product Safety; D005260:Female; D005602:France; D005853:Geriatrics; D006757:Hospital Units / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007668:Kidney / Q000378:metabolism; D007676:Kidney Failure, Chronic / Q000378:metabolism; D008297:Male; D008826:Microbial Sensitivity Tests; D017410:Practice Guidelines as Topic; D012494:Sampling Studies; D012958:Societies, Scientific / Q000592:standards
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin