Multiple-daily aminoglycoside dosing for synergistic therapy in adults, children and neonates

Aminoglycosides can be used in combination with some cell-wall–active drugs (eg penicillins, glycopeptides) to provide useful synergistic killing of some difficult-to-treat pathogens (eg enterococci, viridans streptococci, Bartonella species).

Most studies suggest that a detectable aminoglycoside plasma concentration throughout the dosing period is necessary for effective synergistic activity. Multiple-daily dosing is generally required to achieve this, unless there is substantial kidney impairment. Once-daily dosing of gentamicin is not yet widely accepted for use as synergistic therapy. See Gentamicin for the treatment of infective endocarditis for further details.

Seek expert advice for the management of patients treated with multiple-daily aminoglycoside dosing for synergistic therapy in adults, children and neonates.

If plasma concentration monitoring is indicated, see Multiple-daily aminoglycoside dosing for synergistic therapy: plasma concentration monitoring in adults, children and neonates for monitoring advice.