Vol.56 No.6 November 2008
Clinical efficacy of aminoglycosides at Kyorin University Hospital -Comparison of clinical efficacy and adverse events by administration frequency based on pharmacokineticpharmacodynamic theory-
1)Department of Pharmacy, Kyorin University Hospital, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan
2)Department of General Medicine, Kyorin University School of Medicine
Abstract
The importance of the PK-PD theory in various antibacterial therapy is reported.
The PK-PD parameter in aminoglycosides(AGs) is considered to be Cmax/MIC and once-daily dosage (OD) is said to be more advantageous in clinical response and adverse effects suppression than multiple daily dosage(MDD).
We compared the clinical response and adverse effects in OD and MDD groups for 362 cases administered amikacin(AMK), dibekacin(DKB), gentamicin(GM), isepamicin(ISP), tobramycin(TOB) from January 1 to December 31 2006.
In the MDD groups AMK and GM peak concentration were not effective.
In the duration, in the OD groups GM and the MDD groups ISP were significantly short. (GM: p=0.0226, ISP: p=0.0263)
No statistically significant difference was seen between groups in changes in peripheral white blood cell count or serum CRP or whether detected bacteria disappeared.
No rise in SCr was seen in advers effects of ISP in the MDD groups. (p=0.0465)
We are not able to prove a predicted difference from a PK-PD theory by the dosage and dosage interval that was clinical administered, but our results suggest that reexamination that included the increase dosage was necessary.
Key word
aminoglycosides, PK-PD parameters, once a day, therapeutic drug monitoring
Received
May 2, 2008
Accepted
July 10, 2008
Jpn. J. Chemother. 56 (6): 625-630, 2008
