Dosing strategy based on prevailing aminoglycoside minimum inhibitory concentration in India: Evidence and issues

Indian J Med Microbiol. 2017 Oct-Dec;35(4):585-587. doi: 10.4103/ijmm.IJMM_17_386.

Abstract

Aminoglycosides are important agents used for treating drug-resistant infections. The current dosing regimen of aminoglycosides does not achieve sufficient serum level concentration for the infected bacterial pathogen interpreted as susceptible based on laboratory testing. Minimum inhibitory concentration was determined for nearly 2000 isolates of Enterobacteriaceae and Pseudomonas aeruginosa by broth microdilution method. Results were interpreted based on CLSI and EUCAST interpretative criteria and the inconsistencies in the susceptibility profile were noted. This study provides insights into the inconsistencies existing in the laboratory interpretation and the corresponding clinical success rates. This urges the need for revising clinical breakpoints for amikacin, to resolve under dosing leading to clinical failure.

MeSH terms

  • Aminoglycosides / administration & dosage*
  • Aminoglycosides / pharmacology*
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacology*
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / microbiology
  • Humans
  • India
  • Microbial Sensitivity Tests
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / drug effects*
  • Pseudomonas aeruginosa / isolation & purification

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents