DOSING OF AMINOGLYCOSIDES TO RAPIDLY ATTAIN PHARMACODYNAMIC GOALS ANDHASTEN THERAPEUTIC RESPONSE BY USING INDIVIDUALIZED PHARMACOKINETIC MONITORING OF PATIENTS WITH PNEUMONIA CAUSED BY GRAM-NEGATIVE ORGANISMS

Achieving a peak aminoglycoside concentration (C-max)/MIC of greater t han or equal to 10 within 48 h of initiation of therapy for pneumonia caused by gram-negative organisms results in a 90% probability of ther apeutic response by day 7. Targeting an MIC of 1 mu g/ml, empirical am inoglycoside loading doses of 348 (25th- to 75th-percentile range, 275 to 432) mg were calculated to obtain a C-max/MIC of 10 in our patient population. Individualized pharmacokinetic monitoring coupled,vith MI C data should determine subsequent dosing regimens to minimize the pot ential for toxicity and maximize the probability of clinical response.