THE EVOLUTION OF AMINOGLYCOSIDE THERAPY - A SINGLE DAILY DOSE

After five decades of clinical use, aminoglycosides continue to be imp ortant antibiotics in the management of gram-negative infections. Howe ver, antimicrobial therapy with gentamicin, tobramycin, amikacin and n etilmicin has been complicated by the risk of nephrotoxicity and ototo xicity. Considerable research has been conducted to determine the opti mal aminoglycoside dosing method that will produce maximum efficacy wi th minimal toxicity. Experimental data and clinical experience suggest that aminoglycoside regimens modified from standard dosing (every eig ht to 12 hours) to once-daily dosing may provide improved clinical out comes, with reduced toxicity and cost of therapy. Gentamicin, tobramyc in and netilmicin may be administered in single daily dosages ranging from 4 to 7 mg per kg, and amikacin may be given in a dosage of 15 to 20 mg per kg once daily.