Abstract |
In an examination of the relationships among plasma aminoglycoside concentrations, the minimal inhibitory concentration (MIC) for the infecting organism, and therapeutic outcome, data were analyzed from 236 patients with gram-negative bacterial infections who were participants in four clinical trials of gentamicin, tobramycin, and amikacin. Clinical response to therapy occurred in 188 (80%) patients. Elevated maximal and mean peak aminoglycoside concentration/MIC ratios were strongly associated with clinical response (P less than .00001 and P less than .0001, respectively). A graded dose-response effect was found between an increasing maximal peak concentration/MIC ratio and clinical response. By logistic regression the peak concentration/MIC ratios were associated significantly with clinical response after adjustment for underlying severity of illness and other factors correlated with response. These results demonstrate that a high peak concentration relative to the MIC for the infecting organism is a major determinant of the clinical response to aminoglycoside therapy.
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Authors | R D Moore, P S Lietman, C R Smith |
Journal | The Journal of infectious diseases
(J Infect Dis)
Vol. 155
Issue 1
Pg. 93-9
(Jan 1987)
ISSN: 0022-1899 [Print] United States |
PMID | 3540140
(Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Gentamicins
- Amikacin
- Tobramycin
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Amikacin
(blood, pharmacology, therapeutic use)
- Bacterial Infections
(drug therapy, microbiology)
- Clinical Trials as Topic
- Double-Blind Method
- Female
- Gentamicins
(blood, pharmacology, therapeutic use)
- Gram-Negative Bacteria
(drug effects, isolation & purification)
- Humans
- Male
- Microbial Sensitivity Tests
- Middle Aged
- Random Allocation
- Tobramycin
(blood, pharmacology, therapeutic use)
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