Single Daily Dose of Aminoglycosides

Marcel Dekker, Inc. 270 Madison Avenue, New York, New York 10016 

Monitoring of SDD is still in its infancy and quite different from conventional models in that peaks in excess of 20 pg/mL for gentamicin and tobramycin are anticipated. Dosages used varied from 3 to 7 mg/kg/day for gentamicin, tobramycin, and netilmicin and from 14 to 20 mg/kg/day for amikacin. Modification is recommended for increasing dosing interval to every 36 hours for creatinine clearance between 40 and 59 mL/min and to 48 hours for creati- 

Reportedly, SDD of aminoglycosides results in less accumulation in renal cells because the reabsorption of aminoglycoside is saturation dependent (30,31). Animal studies have shown that SDD allows a longer period when there is no additional drug exposure with reduced aminoglycoside burden for cellular processing (26), there is theoretically less inherent toxicity. 

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Bertino JS, Rotschafer JC. Single daily dosing of aminoglycosides A concept whose time has not yet come. Clin Infect Dis 1997 24 820-823. 

Gilbert DN. Meta-analyses are no longer required for determining the efficacy of single daily dosing of aminoglycosides. Clin Infect Dis 1997 24 816-819. 

Barza M, loannidis JP, Cappelleri JC, Lau J. Single or multiple daily doses of aminoglycosides a meta-analysis. BMJ 1996 312 338-345. 

Aminoglycosides are often used in patients with gram-negative bacillary pneumonia. Single daily dosing may be of particular importance in patients with pneumonia, since this regimen can increase the peak concentration of the aminoglycosides in bronchial secretions. 

Marra F, Partoni N, Jewesson P, Aminoglycoside administrations as a single daily dose An improvement to current practice or a repeat of previous errors Drugs 1996 52 344-376. 

Ali MZ, Goetz MB. A meta-analysis of the relative efficacy and toxicity of single daily dosing versus multiple daily dosing aminoglycosides. Clin Infect Dis 1997 24 796-809. 

Nordstrom L, Ringberg H, Cronberg S, Tjernstrom O, Walder M. Does administration of an aminoglycoside in a single daily dose affect its efficacy and toxicity J Antimicrob Chemother 1990 25 159-173. 

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