Therapeutic Monitoring and Management of Aminoglycosides Based on PK/PD: A Scope Review
DOI:
https://doi.org/10.55892/jrg.v9i20.3159Keywords:
aminoglycosides, therapeutic drug monitoring, pharmacokinetics, pharmacodynamics, amikacinAbstract
The present study aims to synthesize the available evidence on the therapeutic drug monitoring of aminoglycosides and therapeutic adjustment based on PK/PD principles. A scoping review with a systematic search was conducted, aligned with the recommendations of the Joanna Briggs Institute for scoping reviews and the PRISMA-ScR guidelines. The descriptors and their synonyms were searched in Portuguese, English, and Spanish in the PubMed and LILACS databases. A total of 1,001 records were identified, and ultimately 14 articles were included. The included articles were predominantly observational, with a predominance of retrospective designs. Therapeutic drug monitoring of aminoglycosides was performed mainly using peak/trough sampling strategies. Efficacy assessments were mostly based on Cmax/MIC, with a smaller proportion of studies also citing AUC/MIC. Safety was generally established through targets for Cmin. The evidence synthesized in this review highlights the urgent need to standardize the efficacy and safety metrics used in aminoglycoside monitoring. In this context, Therapeutic Drug Monitoring based on PK/PD principles emerges as a potentially relevant tool for optimizing the use of aminoglycosides, especially in critically ill populations, in which pharmacokinetic variability is substantial.
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