SINGLE DAILY DOSING OF AMINOGLYCOSIDES

To evaluate the rationale behind dosing aminoglycosides as a single da ily dose versus traditional dosing approaches, we conducted a MEDLINE search to identify all pertinent articles, and also reviewed the refer ences of all articles. Single daily dosing of aminoglycosides is not a new concept, having been examined since 1974. The advantages of this regimen include optimum concentration-dependent bactericidal activity, longer dosing intervals due to the postantibiotic effect (PAE), and p revention of bacterial adaptive resistance. Because of longer dosing i ntervals, toxicity may also be delayed or reduced. Costs may be reduce d due to decreased monitoring and administration. Clinically, the regi men has been implemented in various patient populations with reported success. Questions remain, however, about optimum dose, peak and troug h serum concentrations, and dose adjustment in patients with renal imp airment or neutropenia. More clinical experience with this method in l arge numbers of patients has to be published. Pharmacists can be instr umental in monitoring patients receiving once-daily therapy and by edu cating health care professionals as to the rationale behind the therap y.