Once-daily dosing of aminoglycosides: review and recommendations for clinical practice

J Antimicrob Chemother. 1997 Jun;39(6):677-86. doi: 10.1093/jac/39.6.677.


The use of higher-dose, extended interval (i.e., once-daily) aminoglycoside regimens to optimize bacterial killing is justified by a pharmacodynamic principle of aminoglycosides, namely concentration-dependent killing, and by the partial attribution of the toxicity of aminoglycosides to prolonged serum concentrations. Numerous in-vitro and animal studies have supported using once-daily aminoglycoside dosing. Clinical studies show at least equal effectiveness and no greater toxicity when compared with traditional regimens. A dose of 5-7 mg/kg of gentamicin, tobramycin, or netilmicin, with at least a 24 h dosing interval should be employed and a similar regimen can be applied to amikacin dosing. As yet, there are some patient populations that have not been adequately studied to determine whether or not once-daily aminoglycoside dosing would be a better choice than traditional dosing regimens.

Publication types

  • Review

MeSH terms

  • Aminoglycosides
  • Animals
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects
  • Anti-Bacterial Agents / economics
  • Bacterial Infections / drug therapy*
  • Drug Administration Schedule
  • Drug Monitoring
  • Humans
  • Practice Guidelines as Topic


  • Aminoglycosides
  • Anti-Bacterial Agents