• S M Watling and J F Dasta.
• Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, PA.
• Ann Pharmacother. 1993 Mar 1; 27 (3): 351-7.

ObjectiveFactors affecting aminoglycoside dosing requirements in critically ill adult patients were reviewed.Data SourcesA literature search was performed from 1979 to 1992 and articles pertaining to aminoglycoside dosing were obtained.Study SelectionOnly studies appearing in peer-reviewed journals were selected. Topics selected included: bactericidal kill kinetics, once-daily dosing regimens, critical illness, toxicity, aminoglycosides, intensive care unit, and lung penetration.ConclusionsStudies suggest that larger initial aminoglycoside doses are necessary in critically ill patients (tobramycin/gentamicin 3 mg/kg or amikacin 9 mg/kg) to achieve adequate peak serum concentrations. Current studies have not shown an increase in the incidence of aminoglycoside toxicity when using these larger initial doses. Follow-up monitoring is dependent upon the patient's physiology and risk factors for aminoglycoside-induced toxicity.

16 keywords...

hide…