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Antimicrobial Agents and Chemotherapy, July 1998, p. 1842-1844, Vol. 42, No. 7
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Dosing of Aminoglycosides To Rapidly Attain Pharmacodynamic Goals and Hasten Therapeutic Response by Using Individualized Pharmacokinetic Monitoring of Patients with Pneumonia Caused by Gram-Negative Organisms

A. D. M. Kashuba,1 J. S. Bertino Jr.,1,2,3 and A. N. Nafziger1,3,*

Clinical Pharmacology Research Center,1 Department of Pharmacy Services,2 and Department of Medicine,3 Bassett Healthcare, Cooperstown, New York

Received 26 June 1997/Returned for modification 18 January 1998/Accepted 27 April 1998

Achieving a peak aminoglycoside concentration (Cmax)/MIC of >= 10 within 48 h of initiation of therapy for pneumonia caused by gram-negative organisms results in a 90% probability of therapeutic response by day 7. Targeting an MIC of 1 µg/ml, empirical aminoglycoside loading doses of 348 (25th- to 75th-percentile range, 275 to 432) mg were calculated to obtain a Cmax/MIC of 10 in our patient population. Individualized pharmacokinetic monitoring coupled with MIC data should determine subsequent dosing regimens to minimize the potential for toxicity and maximize the probability of clinical response.

* Corresponding author. Mailing address: Clinical Pharmacology Research Center, Bassett Healthcare, 1 Atwell Rd., Cooperstown, NY 13326-1394. Phone: (607) 547-3399. Fax: (607) 547-6914. E-mail: nafziger{at}usa.net.

Antimicrobial Agents and Chemotherapy, July 1998, p. 1842-1844, Vol. 42, No. 7
0066-4804/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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