Author/Editor		Beović, Bojana
Title		Odmerjanje aminoglikozidov enkrat dnevno
Translated title		Once-daily dosing of aminoglycosides
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 66, št. 5
Publication year		1997
Volume		str. 249-53
Language		slo
Abstract		Background. Once-daily dosing of aminoglycosides bas been used more and more often for the last few years. In the present paper, theoretical backgroud, clinical experiences and recommendations for everyday practice are reviewed. The pharmacodynamic properties of aminoglycosides in favour of the once-daily dosing are the correlation of their antibacterial efficacy and the ratio of the peak serum concentration to minimal inhibitory concentration (MIC), the postantibiotic effect and the adaptive resistance. Based on some experimental results, toxicity could be lowered in once-daily dosing regimen as well Clinical experiences bave confirmed experimental results and showed that once-daily dosing of aminoglycosides is at least equally effective and toxic as the conventional multiple dosing regimen in many indications. In some groups of patients and in some diseases experiences are still lacking. Since after one large dose given every 24 hours, peak serum concentrations are more likely to be high enough and trough concentrations are more likely to be low enough, monitoring of the serum concentrations seems to be less important in once-daily dosing. Conclusions. At present, once-daily dosing of aminoglycosides is recommended in many indications. But nevertheless, until more data are available, careful planning of dosing and monitoring is needed in every patient.
Summary		Izhodišča. Aminoglikozidni antibiotiki se v zadnjem času vedno pogosteje uporabljajo v enkratnih dnevnih odmerkih. Pregledni članek obravnava teoretična izhodišča enkratnega dnevnega odmerjanja, dosedanje izkušnje in navodila za klinično uporabo. Med farmakodinamskimi lastnostmi, ki omogočajo enkratno dnevno odmerjanje aminoglikozidov, so najpomembnejše odvisnost učinkovitosti od razmerja med najvišjo serumsko koncentracijo antibiotika in minimalno inhibitorno koncentracijo (MIK), postantibiotični učinek in adaptivna rezistenca. Raziskave in vitro in na živalih so pokazale, da so enkratni dnevni odmerki verjetno tudi manj toksični. Dosedanje klinične izkušnje kažejo, da so enkratni dnevni odmerki vsaj enako učinkoviti in enako toksični od običajnega načina odmerjanja. Pri nektarih boleznih in pri nekaterih skupinah bolnikov so izkušnje še skope. Po enkratnem velikem dnevnem odmerku aminoglikozidov so najvišje serumske koncentracije zanesljiveje dovolj nizke kot pri večkratnem dnevnem odmerjanju aminoglikozidov verjetno potrebnno manj pogosto. Zaključki. Enkratno dnevno odmerjanje aminoglikozidov danes priporočajo za zdravljenje številnih bolezni. Dokler ne bomo imeli več podatkov, pa je še vedno treba ob vsakem bolniku presoditi, kako ga bomo zdravili in kako bomo zdravljenje nadzorovali.
Descriptors		ANTIBIOTICS, AMINOGLYCOSIDE ANIMALS