Extended interval aminoglycoside dosing: from concept to clinic

Area of Science:

• Pharmacology
• Infectious Diseases
• Clinical Pharmacy

Background:

• Extended-interval aminoglycoside dosing (EIAD) has historical roots dating back to the 1970s.
• Early research focused on optimizing dosage regimens to minimize toxicity and maximize efficacy.
• Pharmacodynamic understanding has driven the increasing adoption of EIAD in clinical practice.

Purpose of the Study:

• To review the historical development and current status of extended-interval aminoglycoside dosing.
• To highlight the pharmacodynamic principles underlying EIAD.
• To identify ongoing controversies and areas for future research in aminoglycoside administration.

Main Methods:

• Literature review of historical trials and clinical studies on aminoglycoside dosing.
• Analysis of pharmacodynamic data to support EIAD principles.
• Examination of survey data on the adoption of EIAD in hospitals.

Main Results:

• EIAD has evolved from experimental approaches to a common practice, with approximately 75% of US hospitals adopting it by 1998.
• A deeper understanding of aminoglycoside pharmacodynamics has facilitated the successful implementation of EIAD.
• Controversies remain concerning the optimal duration of the drug-free interval and patient exclusion criteria.

Conclusions:

• Extended-interval aminoglycoside dosing is a well-established and widely accepted practice.
• Continued research is needed to refine protocols regarding drug-free intervals and patient selection for EIAD.
• Optimal use of aminoglycosides continues to be an evolving area of clinical practice.