Pharmacokinetics of Aminoglycosides
This chapter describes pharmacokinetic parameters, factors related to elimination, methods to control serum concentrations, and clinical results of controlling serum concentrations of these three commonly used aminoglycoside agents and the newly introduced netilmicin. Aminoglycoside antibiotics are among the most useful group of antimicrobial agents for Gram-negative infections. Improved treatment response has been associated with obtaining therapeutic serum concentrations of aminoglycosides early in a treatment course. Aminoglycoside nephrotoxicity is much more complex and difficult to separate from complications secondary to underlying disease. The pharmacokinetic parameters of aminoglycoside antibiotics are simplified in comparison to many other pharmacologic agents. Aminoglycoside antibiotics are characterized by linear pharmacokinetic principles, indicating a direct proportionality between increasing dose and area under the concentration time curve. The aminoglycoside antibiotics are thought to distribute to a pharmacologic space very similar to the physiological space of the extracellular fluid compartment.