Knudsen L M, Frimodt-Møller N, Hansen M T, Hippe E
Medicinsk-haematologisk afdeling L, Københavns Amts Sygehus i Herlev.
Ugeskr Laeger. 1993 May 10;155(19):1436-41.
Aminoglycosides are among the most active antimicrobial agents against Gram-negative infections, but they also share the potential for oto- and nephrotoxicity. Animal studies have shown that dosing aminoglycosides once daily is more efficient and less nephrotoxic than the conventional multiple daily dosing regimens. Pharmacokinetic and microbiological data support this finding. Clinical trials confirm that once-daily dosing is more efficient and less toxic than multiple daily dosing. The two most important risk factors for nephrotoxicity seem to be the duration of aminoglycoside treatment and high trough levels of aminoglycoside. Netilmicin and amikacin are the drugs most often used in clinical trials of once-daily dosing regimens. Recommendations for once-daily dosing of netilmicin are given.
氨基糖苷类药物是抗革兰氏阴性菌感染最有效的抗菌药物之一,但它们也有耳毒性和肾毒性的风险。动物研究表明,与传统的每日多次给药方案相比,氨基糖苷类药物每日给药一次更有效且肾毒性更小。药代动力学和微生物学数据支持这一发现。临床试验证实,每日一次给药比每日多次给药更有效且毒性更小。肾毒性的两个最重要危险因素似乎是氨基糖苷类药物的治疗持续时间和高谷浓度。奈替米星和阿米卡星是每日一次给药方案临床试验中最常用的药物。给出了奈替米星每日一次给药的建议。