Cost Considerations in Therapeutic Drug Monitoring of Aminoglycosides

Joseph S. Bertino, Keith A. Rodvold, Christopher J. Destache

Research output: Contribution to journalReview article

38 Citations (Scopus)

Abstract

Aminoglycoside antibiotics are very important in the treatment of Gram-negative infections and as synergistic agents for the treatment of staphylococcal and streptococcal (group B streptococci and enterococci) infections. However, these agents have a narrow therapeutic index. Thus, a number of new antibiotics have been introduced in an attempt to reduce the number of patients treated with aminoglycosides. Unfortunately, these new antibiotics tend to be costly, and are often associated with development of resistance and treatment failure. Data suggest that a pharmacokinetic/pharmacodynamic relationship exists for some aspects of efficacy and toxicity of aminoglycosides. Serum drug concentrations and/or tissue accumulation are related to the development of nephrotoxicity, and individualised pharmacokinetic monitoring may decrease rates of nephrotoxicity. Peak serum drug concentrations and the ratio of peak serum drug concentration to minimum inhibitory concentration appear to correlate with clinical efficacy in the treatment of patients with bacteraemia or pneumonia. Therapeutic drug monitoring (TDM) has been used to optimise aminoglycoside therapy and reduce toxicity. Cost-effective approaches to drug selection and TDM are important considerations in the proper use of aminoglycosides.

Original languageEnglish
Pages (from-to)71-81
Number of pages11
JournalClinical Pharmacokinetics
Volume26
Issue number1
DOIs
StatePublished - 1994

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Drug Monitoring
Aminoglycosides
Costs and Cost Analysis
Anti-Bacterial Agents
Pharmaceutical Preparations
Pharmacokinetics
Serum
Therapeutics
Streptococcus agalactiae
Enterococcus
Microbial Sensitivity Tests
Bacteremia
Infection
Treatment Failure
Pneumonia

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Cost Considerations in Therapeutic Drug Monitoring of Aminoglycosides. / Bertino, Joseph S.; Rodvold, Keith A.; Destache, Christopher J.

In: Clinical Pharmacokinetics, Vol. 26, No. 1, 1994, p. 71-81.

Research output: Contribution to journalReview article

Bertino, Joseph S. ; Rodvold, Keith A. ; Destache, Christopher J. / Cost Considerations in Therapeutic Drug Monitoring of Aminoglycosides. In: Clinical Pharmacokinetics. 1994 ; Vol. 26, No. 1. pp. 71-81.
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