Selective toxicity aminoglycosides

Routine monitoring of serum concentrations is currently used for a select few antimicrobials (e.g., aminoglycosides, chloramphenicol, and vancomycin) in an attempt to minimize toxicity and maximize efficacy. 

The clinician should have an understanding of in vivo antimicrobial agent disposition in order to select the most appropriate therapy for a given infection and to help monitor for clinical or bacteri-ologic efficacy. Serum concentration monitoring is the most common method used to attempt to maximize efficacy and minimize toxicity of antimicrobials. Since most antimicrobials are well tolerated at their usual doses, only a select few agents (e.g., aminoglycosides, chloramphenicol, and vancomycin) are monitored routinely in the current clinical environment. There are a number of direct and indirect methods that are used to quantify the concentration of antimicrobial in an experimental sample. 

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