Ward Kristy, Theiler Regan N
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas 77555-0587, USA.
Clin Obstet Gynecol. 2008 Sep;51(3):498-506. doi: 10.1097/GRF.0b013e31818091cd.
Gentamicin, an aminoglycoside with broad antimicrobial activity, is commonly used in both obstetrics and gynecology. Traditional dosing regimens for gentamicin have called for 3 times daily dosing, but recent insights into the pharmacodynamics of the drug have led to multiple studies of once-daily dosing regimens. Many studies have demonstrated efficacy, safety, and economy of the 24-hour dosing interval, resulting in recommendations that this become the standard for aminoglycoside administration. However, because of the unique considerations for drug administration in pregnant and postpartum women, the once-daily dosing regimens have not been widely adopted. Additional studies in pregnant and postpartum women have demonstrated therapeutic noninferiority, no increase in adverse events, and significant cost savings with once-daily dosing versus 3 times daily dosing of gentamicin. We review the literature and present rationale based on multiple controlled studies supporting single-daily dosing of gentamicin, 5 mg/kg/d actual body weight, for many common obstetrics-gynecology infections.
庆大霉素是一种具有广泛抗菌活性的氨基糖苷类药物，常用于妇产科。传统的庆大霉素给药方案要求每日给药3次，但最近对该药物药效学的深入了解引发了对每日一次给药方案的多项研究。许多研究已经证明了24小时给药间隔的有效性、安全性和经济性，因此有人建议将其作为氨基糖苷类药物给药的标准。然而，由于孕妇和产后妇女给药有独特的考虑因素，每日一次给药方案尚未得到广泛采用。对孕妇和产后妇女的进一步研究表明，与庆大霉素每日3次给药相比，每日一次给药在治疗上非劣效，不良事件没有增加，而且成本显著降低。我们回顾了文献，并基于多项对照研究提出了支持对许多常见妇产科感染采用每日一次给予庆大霉素（实际体重5mg/kg/d）的理由。
