Once-daily aminoglycoside administration in gram-negative sepsis. Economic and practical aspects

A fuller understanding of the pharmacodynamics of aminoglycoside antibiotics now exists compared with when they were introduced. Recent findings have shown that once-daily dosage regimens of aminoglycosides are as effective as bd or tid regimens in the treatment of Gram-negative sepsis. However, radical changes in dosage frequency based on this knowledge are resisted by some physicians because of fears about the peak concentration toxicity of aminoglycosides. These fears have been shown to be misplaced. The delay in the translation of research findings into practice may be attributable to the sheer quantity of medical literature and the limited time that clinicians have available to read it. Because healthcare resources are finite, physicians are increasingly becoming aware of the need to use drug therapy in the most cost-effective way. An important component of aminoglycoside therapy that may persuade clinicians to change their practice is the organised consideration of the various costs associated with different administration regimens. This review examines the source of those costs, and endorses once-daily dosage of aminoglycosides from both an economic and practical viewpoint.