Gentamicin and tobramycin dosing guidelines: an evaluation

The provision of pharmacokinetic dosing services has become a cornerstone of clinical pharmacy practice in many institutions. As these services expand, more pharmacists will become involved, and the need for a structured, uniform approach to the provision of these services may be necessary. Therefore, this article discusses specific approaches (i.e., guidelines) to the most common clinical conditions that the pharmacist may encounter. The goal is to promote consistent interpretation and application of clinical and kinetic data by the members of our aminoglycoside dosing service. The guidelines provide a structured yet adaptive approach to the clinical use of gentamicin and tobramycin. The major areas of controversy that were encountered in developing these guidelines are discussed, and the guidelines are presented. These guidelines currently are used to standardize our pharmacokinetic dosing service and as a tool for educating new pharmacists to their role and responsibilities as members of the pharmacokinetic consultation team. Additionally, these guidelines are being used as criteria for the assessment of quality assurance in the area of clinical pharmacokinetics.