icu

Once-Daily Dosing of Aminoglycosides

　　Edward Timm, PharmD,[13] of Albany Medical Center, Schenectady, New York, reviewed the data supporting once-daily dosing of aminoglycosides in ICU patients. He outlined the rationale for such a once-daily dose strategy by emphasizing 3 points:
1. This strategy takes advantage of concentration-dependent killing of microorganisms and allows for maximal antibiotic efficacy;
2. This strategy minimizes nephrotoxicity and ototoxicity and has an added advantage of decreasing medication errors by using a consistent dose that is not based on the interpretation of aminoglycoside levels; and
3. Dollar costs are decreased when the costs of mixing and hanging drugs more than once a day and the laboratory charges incurred when getting levels are considered.
Dr. Timm suggested that once-daily aminoglycoside therapy is appropriate for many patient populations. However, he indicated that not all patients are candidates for this dosing regimen. Specifically, there are no data supporting this dosing strategy in patients with meningitis, endocarditis, burns, as well as in patients who are pregnant or patients who have undergone stem cell transplant.