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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Management of aminoglycosides in the intensive care unit

Elizabeth A Radigan1, Neil A Gilchrist, Melissa A Miller

  • 1Department of Pharmacy, Infectious Diseases, UMass Memorial Medical Center, Worcester, MA 01655, USA. elizabeth.radigan@umassmemorial.org

Journal of Intensive Care Medicine
|September 15, 2010
PubMed

Insights

Aminoglycosides are crucial bactericidal agents for treating gram-negative infections, especially with rising fluoroquinolone resistance. Optimizing dosing strategies can enhance efficacy and minimize risks like nephrotoxicity and ototoxicity.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Increasing global antibacterial resistance necessitates alternative treatment strategies.
  • Rising fluoroquinolone resistance may increase reliance on aminoglycosides for gram-negative infections.

Purpose of the Study:

  • To review the role and optimal use of aminoglycosides in treating bacterial infections.
  • To discuss dosing strategies and potential toxicities associated with aminoglycoside therapy.

Main Methods:

  • Literature review of aminoglycoside pharmacology, clinical applications, and toxicity.
  • Analysis of dosing strategies, including multiple daily dosing and high-dose, extended-interval dosing.

Main Results:

  • Aminoglycosides exhibit potent bactericidal activity against gram-negative pathogens.
  • They can be effective against gram-positive infections when combined with cell wall active agents.
  • Optimized dosing aims to improve pharmacokinetic/pharmacodynamic properties, potentially increasing efficacy and reducing toxicity.

Conclusions:

  • Aminoglycosides remain vital for treating various severe infections, including bacteremia and pneumonia.
  • Careful serum monitoring and judicious use are essential to mitigate nephrotoxicity and ototoxicity.
  • Dosing optimization is key to maximizing the therapeutic benefit of aminoglycosides.

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