Optimization of Anti-Pseudomonal Antibiotics for Cystic Fibrosis Pulmonary Exacerbations: V. Aminoglycosides

David C. Young; Jeffery T. Zobell; Chris Stockmann; Dustin Waters; Krow Ampofo; Catherine M.T. Sherwin; Michael G. Spigarelli

Optimization of Anti-Pseudomonal Antibiotics for Cystic Fibrosis Pulmonary Exacerbations: V. Aminoglycosides

David C. Young, Jeffery T. Zobell, Chris Stockmann, Dustin Waters, Krow Ampofo, Catherine M.T. Sherwin, Michael G. Spigarelli

Wright State University

Research output: Contribution to journal › Article › peer-review

Abstract

Intravenous (IV) anti&hyphen;pseudomonal aminoglycosides (i.e., amikacin and tobramycin) have been shown to be tolerable and effective in the treatment of acute pulmonary exacerbations (APEs) in both pediatric and adult patients with cystic fibrosis. The aim of this review is to provide an evidence&hyphen;based summary of pharmacokinetic/pharmacodynamic, tolerability, and efficacy studies utilizing IV amikacin, gentamicin, and tobramycin in the treatment of APE and to highlight areas where further investigation is needed. The Cystic Fibrosis Foundation Pulmonary Guidelines recommend that once&hyphen;daily administration of aminoglycosides is preferred over three times per day in the treatment of an APE. The literature supports dosing ranges for amikacin and tobramycin of 30–35 and 7–15 mg/kg/day, respectively, given once daily, with subsequent doses determined by therapeutic drug concentration monitoring. The literature does not support the routine use of gentamicin in the treatment of APE due to a lack of studies showing efficacy and evidence indicating an increased risk of nephrotoxicity. Further studies are needed to determine the optimal dosing strategy of amikacin in the treatment of an APE, and to further identify risk factors and determinants that influence the development of P. aeruginosa resistance with once&hyphen;daily administration of tobramycin. Pediatr Pulmonol. 2013; 48:1047–1061. © 2013 Wiley Periodicals, Inc.

Original language	American English
Journal	Pediatric Pulmonology
Volume	48
State	Published - Nov 1 2013

Disciplines

Medical Specialties
Medicine and Health Sciences
Pediatrics

Cite this

@article{48ea338d2bbb4df1b4a940ce421e5ed2,

title = "Optimization of Anti-Pseudomonal Antibiotics for Cystic Fibrosis Pulmonary Exacerbations: V. Aminoglycosides",

abstract = " Intravenous (IV) anti&hyphen;pseudomonal aminoglycosides (i.e., amikacin and tobramycin) have been shown to be tolerable and effective in the treatment of acute pulmonary exacerbations (APEs) in both pediatric and adult patients with cystic fibrosis. The aim of this review is to provide an evidence&hyphen;based summary of pharmacokinetic/pharmacodynamic, tolerability, and efficacy studies utilizing IV amikacin, gentamicin, and tobramycin in the treatment of APE and to highlight areas where further investigation is needed. The Cystic Fibrosis Foundation Pulmonary Guidelines recommend that once&hyphen;daily administration of aminoglycosides is preferred over three times per day in the treatment of an APE. The literature supports dosing ranges for amikacin and tobramycin of 30–35 and 7–15 mg/kg/day, respectively, given once daily, with subsequent doses determined by therapeutic drug concentration monitoring. The literature does not support the routine use of gentamicin in the treatment of APE due to a lack of studies showing efficacy and evidence indicating an increased risk of nephrotoxicity. Further studies are needed to determine the optimal dosing strategy of amikacin in the treatment of an APE, and to further identify risk factors and determinants that influence the development of P. aeruginosa resistance with once&hyphen;daily administration of tobramycin. Pediatr Pulmonol. 2013; 48:1047–1061. © 2013 Wiley Periodicals, Inc.",

author = "Young, {David C.} and Zobell, {Jeffery T.} and Chris Stockmann and Dustin Waters and Krow Ampofo and Sherwin, {Catherine M.T.} and Spigarelli, {Michael G.}",

year = "2013",

month = nov,

day = "1",

language = "American English",

volume = "48",

journal = "Pediatric Pulmonology",

}

TY - JOUR

T1 - Optimization of Anti-Pseudomonal Antibiotics for Cystic Fibrosis Pulmonary Exacerbations: V. Aminoglycosides

AU - Young, David C.

AU - Zobell, Jeffery T.

AU - Stockmann, Chris

AU - Waters, Dustin

AU - Ampofo, Krow

AU - Sherwin, Catherine M.T.

AU - Spigarelli, Michael G.

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Intravenous (IV) anti&hyphen;pseudomonal aminoglycosides (i.e., amikacin and tobramycin) have been shown to be tolerable and effective in the treatment of acute pulmonary exacerbations (APEs) in both pediatric and adult patients with cystic fibrosis. The aim of this review is to provide an evidence&hyphen;based summary of pharmacokinetic/pharmacodynamic, tolerability, and efficacy studies utilizing IV amikacin, gentamicin, and tobramycin in the treatment of APE and to highlight areas where further investigation is needed. The Cystic Fibrosis Foundation Pulmonary Guidelines recommend that once&hyphen;daily administration of aminoglycosides is preferred over three times per day in the treatment of an APE. The literature supports dosing ranges for amikacin and tobramycin of 30–35 and 7–15 mg/kg/day, respectively, given once daily, with subsequent doses determined by therapeutic drug concentration monitoring. The literature does not support the routine use of gentamicin in the treatment of APE due to a lack of studies showing efficacy and evidence indicating an increased risk of nephrotoxicity. Further studies are needed to determine the optimal dosing strategy of amikacin in the treatment of an APE, and to further identify risk factors and determinants that influence the development of P. aeruginosa resistance with once&hyphen;daily administration of tobramycin. Pediatr Pulmonol. 2013; 48:1047–1061. © 2013 Wiley Periodicals, Inc.

AB - Intravenous (IV) anti&hyphen;pseudomonal aminoglycosides (i.e., amikacin and tobramycin) have been shown to be tolerable and effective in the treatment of acute pulmonary exacerbations (APEs) in both pediatric and adult patients with cystic fibrosis. The aim of this review is to provide an evidence&hyphen;based summary of pharmacokinetic/pharmacodynamic, tolerability, and efficacy studies utilizing IV amikacin, gentamicin, and tobramycin in the treatment of APE and to highlight areas where further investigation is needed. The Cystic Fibrosis Foundation Pulmonary Guidelines recommend that once&hyphen;daily administration of aminoglycosides is preferred over three times per day in the treatment of an APE. The literature supports dosing ranges for amikacin and tobramycin of 30–35 and 7–15 mg/kg/day, respectively, given once daily, with subsequent doses determined by therapeutic drug concentration monitoring. The literature does not support the routine use of gentamicin in the treatment of APE due to a lack of studies showing efficacy and evidence indicating an increased risk of nephrotoxicity. Further studies are needed to determine the optimal dosing strategy of amikacin in the treatment of an APE, and to further identify risk factors and determinants that influence the development of P. aeruginosa resistance with once&hyphen;daily administration of tobramycin. Pediatr Pulmonol. 2013; 48:1047–1061. © 2013 Wiley Periodicals, Inc.

UR - https://corescholar.libraries.wright.edu/pediatrics/284

M3 - Article

VL - 48

JO - Pediatric Pulmonology

JF - Pediatric Pulmonology

ER -

Optimization of Anti-Pseudomonal Antibiotics for Cystic Fibrosis Pulmonary Exacerbations: V. Aminoglycosides

Abstract

Disciplines

Other files and links

Cite this