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Part III: Guidelines for selected antimicrobial use

3.8 Once daily aminoglycosides

  1. Once daily aminoglycoside is an effective, well-established method to achieve therapeutic efficacy while limiting the risk of toxicity and simplifying the processes of dosing and monitoring (162–163).
  2. The addition of an aminoglycoside to β-lactams for sepsis should be discouraged. Combination treatment carries a significant risk of nephrotoxicity without survival benefits (164–165).
  3. With the exception of Enterococcus endocarditis (166), aminoglycosides should not be given for more than one or two doses.
  4. As concentration-dependent antibiotics, dosing of gentamicin and amikacin should keep the maximum serum concentration (Cmax) to minimum inhibitory concentration (MIC) ratio to 8–10 for optimal treatment outcome (167).