title: Once-daily aminoglycoside dosing: An update on current literature.
abstract: OBJECTIVE
  The advantages and disadvantages of once-daily versus conventional dosing of aminoglycoside antibiotics are reviewed.
  
  
  CONCLUSIONS
  Although administration of multiple daily doses remains the standard method of aminoglycoside dosing, once-daily dosing may provide enhanced clinical efficacy and reduced toxicity in selected patient populations; demonstrated pharmacokinetic and pharmacodynamic advantages include enhanced postantibiotic effect and an increased likelihood of a high ratio of serum peak concentration to minimum inhibitory concentration. Published evidence identified in a MEDLINE search covering the period 1985-2014 indicates that once-daily high-dose aminoglycoside therapy generally provides clinical effectiveness equivalent or superior to that of multiple-daily dosing. The risk of nephrotoxicity appears to be comparable with once- and multiple-daily aminoglycoside dosing. Several nomograms have been developed to facilitate once-daily dosing; the Hartford nomogram (using a dose of 7 mg/kg) is the most extensively tested and generally considered the most reliable. However, although those nomograms are convenient to use and may reduce expenses, a daily dosing regimen determined by individualized pharmacokinetic monitoring is likely to be more effective for achieving specific serum concentrations and may be a preferable approach for some patients. Patients who are pregnant or have liver failure, severe renal insufficiency, serious illness, or nutritional deficiency are not appropriate candidates for once-daily dosing.
  
  
  CONCLUSIONS
  Once-daily aminoglycoside dosing is an effective, well-established method to achieve therapeutic efficacy while limiting the risk of toxicity and simplifying the processes of dosing and monitoring.
authors.affiliation: Matthew S. Stankowicz is a Pharm.D. student; Jad Ibrahim is a Pharm.D. student; and Daniel L. Brown, Pharm.D., is Professor of Pharmacy Practice and Director of Faculty Development, Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL. matt_stankowicz@pba.edu.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Stankowicz
authors.affiliation: Matthew S. Stankowicz is a Pharm.D. student; Jad Ibrahim is a Pharm.D. student; and Daniel L. Brown, Pharm.D., is Professor of Pharmacy Practice and Director of Faculty Development, Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL.
authors.forename: Jad
authors.initials: J
authors.lastname: Ibrahim
authors.affiliation: Matthew S. Stankowicz is a Pharm.D. student; Jad Ibrahim is a Pharm.D. student; and Daniel L. Brown, Pharm.D., is Professor of Pharmacy Practice and Director of Faculty Development, Lloyd L. Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Brown
mesh_terms: D000617:Aminoglycosides / Q000008:administration & dosage*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents