Analysis index

1 ml serum

Tobramycin

Netilmicin: External service

Despite the fact that aminoglycosides have been used for many years, the modalities of therapeutic drug monitoring are controversially discussed. New pharmacological findings have led to the concept of a single daily dose (ODA: once-daily aminoglycosides), which is associated with an improved clinical effectiveness and decreased oto- and nephrotoxicity.

Traditionally, peak concentrations between 6 mg/l – 10 mg/l and low levels of < 2 mg/l are assumed for Gentamycin, Tobramycin and Netilmicin. With the introduction of the once-daily administration per day, less toxic side effects are expected overall. Still, with a fixed dose per kg body weight, it is recommended to carry out therapeutic drug monitoring due to the interindividual very differing pharmacokinetics, especially in children, patients with cystic fibrosis or endocarditis. For instance, one therapy model suggests a fixed dose of 7 mg/kg body weight. Only dosage intervals are adjusted according to the outcome levels and an ODA nomogram (Nicolau DP. et al. Antimicrob Ag Chemoth 1995, 39 (3), 650).