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Online ISSN 1827-1596
De Waele J. J. 1, De Neve N. 2
1 Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium;
2 Department of Anesthesiology and Intensive Care Medicine, O. L. Vrouw Hospital Aalst, Aalst, Belgium
Aminoglycosides are potent antibiotics with a renewed interest due to the increase in multidrug resistant infections. Their use in life-threatening infections ‑ in combination with other antibiotics ‑ has been debated due to the lack of clear outcome benefits. However, based on recent pharmacokinetic-pharmacodynamic studies, conventional dosing may be inefficient in a considerable number of patients, which could preclude the efficiency of this potent drug class. Toxicity on the other hand remains a concern, with nephrotoxicity as the most relevant negative effect in the critically ill. Short term, intensively monitored treatment strategies — with monitoring both peak and trough levels — may increase efficacy as well as reduce toxicity in the critically ill patient.