Pharmacy, Health Sciences & Exercise Science

Achievement of Desired Peak to MIC Ratios in Pediatric Aminoglycoside Dosing Regimens in Children: a Retrospective Cohort Study

Presenter Information

Jennifer Tassell, Butler University

Document Type

Oral Presentation

Location

Indianapolis, IN

Subject Area

Pharmacy, Health Sciences & Exercise Science

Start Date

11-4-2014 10:15 AM

End Date

11-4-2014 11:45 AM

Description

Background: Differences in clinical or microbiological failure rates between traditional and extended-interval aminoglycoside dosing regimens have not been identified. However, given the changing bacterial susceptibility patterns across the country, it is unknown whether either of the dosing regimens routinely attains the desired peak based on the infectious organism and the organism's minimum inhibitory concentration (MIC) to the aminoglycoside. The objective of this study was to compare these two dosing strategies with regard to proportion of pediatric patients who attained a desired peak:MIC ratio of 8-10 for IV aminoglycosides.

Methods: This was a retrospective cohort study of patients less than 18 years who received an IV aminoglycoside (either gentamicin, tobramycin, or amikacin) between January 1, 2012 and December 31, 2012. Patients included had a documented positive bacterial culture with susceptibilities and aminoglycoside serum concentrations. Patients' electronic medical records were reviewed to determine demographic data, baseline serum creatinine, aminoglycoside dose and drug used, duration of therapy, and attending physician. Effective peak concentrations were defined as those 8-10 times the documented infectious organism's MIC to the drug used.

Significance: Comparing aminoglycoside attained peak concentrations to anticipated peak concentrations, along with MIC distributions, will allow the determination of optimal dosing strategies to use moving forward to attain the desired peak:MIC ratios of >8:1.

Results: Data is currently being collected with results to be presented at the 2014 Butler University URC.

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Apr 11th, 10:15 AM Apr 11th, 11:45 AM

Achievement of Desired Peak to MIC Ratios in Pediatric Aminoglycoside Dosing Regimens in Children: a Retrospective Cohort Study

Indianapolis, IN

Background: Differences in clinical or microbiological failure rates between traditional and extended-interval aminoglycoside dosing regimens have not been identified. However, given the changing bacterial susceptibility patterns across the country, it is unknown whether either of the dosing regimens routinely attains the desired peak based on the infectious organism and the organism's minimum inhibitory concentration (MIC) to the aminoglycoside. The objective of this study was to compare these two dosing strategies with regard to proportion of pediatric patients who attained a desired peak:MIC ratio of 8-10 for IV aminoglycosides.

Methods: This was a retrospective cohort study of patients less than 18 years who received an IV aminoglycoside (either gentamicin, tobramycin, or amikacin) between January 1, 2012 and December 31, 2012. Patients included had a documented positive bacterial culture with susceptibilities and aminoglycoside serum concentrations. Patients' electronic medical records were reviewed to determine demographic data, baseline serum creatinine, aminoglycoside dose and drug used, duration of therapy, and attending physician. Effective peak concentrations were defined as those 8-10 times the documented infectious organism's MIC to the drug used.

Significance: Comparing aminoglycoside attained peak concentrations to anticipated peak concentrations, along with MIC distributions, will allow the determination of optimal dosing strategies to use moving forward to attain the desired peak:MIC ratios of >8:1.

Results: Data is currently being collected with results to be presented at the 2014 Butler University URC.