Aminoglycoside dosing in diabetes

Studies have evaluated the comparative efficacy, toxicity and costs associa ted with extended-interval vs. standard multiple daily dosing of aminoglyco sides. In this case, an elderly man with diabetes and good renal function a t baseline was switched from standard to extended-interval dosing. During t he course of therapy there was evidence of decreased renal function. Pertin ent literature was searched for, uncovered and critically evaluated to dete rmine if and what evidence supports using extended dosing of aminoglycoside s in this population. No data were found specifically evaluating the differ ent dosing strategies in diabetic patients. However, there were many trials and several meta-analysis located that compared the two dosing strategies, most suggesting at least a cost advantage and possibly less toxicity with extended-interval dosing. Further information is needed to determine whethe r there is a differential risk for toxicity between these dosing regimens i n patient with diabetes.