Question

1. The trough concentration for an aminoglycoside from your patient is much higher than the target trough concentration. After holding the next dose, you should: 1. Decrease the dose 2. Increase the dosage interval

Answer 1

Aminoglycosides have bactericidal activity against most gram-negative bacteria.

A disadvantage of the aminoglycosides is their association with nephetoxicity and ototoxicity, both of which are associated with elevated trough levels and sustained evevated peak levels.

Aminoglycosides eliminate bacteria quickest when their concentration is appreciable above the MIC for organism. It is also exhibit a significant post-antibiotic effect.

1. Decrease the dose level- here selection of practical, convenient doses and administration schedules very important. Odd doses and schedules may lead to errors in administration. Generally if level increases dose should be off.

2. Increase the dosage level of aminoglycosides dosing has gained popularity in recent years. This simplified dosing method is appropriate in young, otherwise healthy patient with sepsis.