Aminoglycosides in cystic fibrosis: a descriptive study of current practice in Australia

Phillips, J.A. and Bell, S.C. (2001) Aminoglycosides in cystic fibrosis: a descriptive study of current practice in Australia. Internal Medicine Journal, 31 1: 23-26. doi:10.1046/j.1445-5994.2001.00010.x


Author Phillips, J.A.
Bell, S.C.
Title Aminoglycosides in cystic fibrosis: a descriptive study of current practice in Australia
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
1445-5994
Publication date 2001-01
Sub-type Article (original research)
DOI 10.1046/j.1445-5994.2001.00010.x
Volume 31
Issue 1
Start page 23
End page 26
Total pages 4
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Aim:
To determine the diversity of clinical practice with respect to aminoglycosides in cystic fibrosis (CF) units within Australia.

Method:
In April 1999, a questionnaire on the use of aminoglycosides was sent to 30 CF units across Australia. Information was collected about drug selection, dosing, monitoring and toxicity with intravenous administration.

Results:
Completed surveys were received from 26 of the 30 units (response rate = 86%) and all units with > 40 patients. Tobramycin was the drug of choice in all but two centres where there was equivalent use of gentamicin and tobramycin. The survey demonstrated a trend in recent years to reduce the number of doses per day with 54% of centres prescribing once daily, 23% twice daily and 23% thrice daily regimens. Initial dosing was generally based on mg/kg per day (mean 8.8, range 7.5-10 mg/kg per day). Dosing by infusion occurred in 11 of 14 units using once-daily dosing and there was equivalent use of bolus and infusion methods for multiple-daily regimens. Drug monitoring depended on dosing regimen. Units using multiple daily regimens monitored using trough ± peak levels, whereas 50% of units using once-daily dosing used two postdose levels to alter dose. Actual toxicity, in particular nephrotoxicity, ototoxicity and vestibular toxicity was reported by 19, 27 and 12% of units, respectively.

Conclusion:
The prescribing, dosing and monitoring of aminoglycosides in CF across Australia varies greatly. This is likely to be due to a lack of definitive evidence as to the optimum use in this patient group.
Keyword Aminoglycosides
Cystic fibrosis
Gentamicin
Tobramycin
Toxicity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Article first published online: 21 December 2001.

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Mon, 14 Mar 2011, 10:47:03 EST