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Clinical Response to Aminoglycoside Therapy: Importance of the Ratio of Peak Concentration to Minimal Inhibitory Concentration
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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Citations
Cited by
Craig, W. A. (1998) · Clinical Infectious Diseases · doi:10.1086/516284 · Cited by 2,908
Roberts, J. A., Abdul-Aziz, M. H., Lipman, J., Mouton, J. W., Vinks, A. A., Felton, T. W., Hope, W. W., Farkas, A., Neely, M. N., Schentag, J. J., et al. (2014) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(14)70036-2 · Cited by 1,046
Optimizing Aminoglycoside Therapy for Nosocomial Pneumonia Caused by Gram-Negative Bacteria
Kashuba, A. D. M., Nafziger, A. N., Drusano, G. L., & Bertino, J. S. (1999) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.43.3.623 · Cited by 380
Augmented Renal Clearance: Implications for Antibacterial Dosing in the Critically Ill
Udy, A. A., Roberts, J. A., Boots, R. J., Paterson, D. L., & Lipman, J. (2010) · Clinical Pharmacokinetics · doi:10.2165/11318140-000000000-00000 · Cited by 377
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Metadata
- Authors
- Moore, R. D., Lietman, P. S., & Smith, C. R.
- Venue
- Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1987-01-01
- Volume
- 155
- Issue
- 1
- Pages
- 93-99
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2132491970
- Cited by
- 1,139
- References
- 0
- FWCI
- 26.83
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Clinical Response to Aminoglycoside Therapy: Importance of the Ratio of Peak Concentration to Minimal Inhibitory Concentration. https://app.cochat.ai/papers/10.1093/infdis/155.1.93
- The paper
- Moore, R. D., Lietman, P. S., & Smith, C. R. (1987). Clinical Response to Aminoglycoside Therapy: Importance of the Ratio of Peak Concentration to Minimal Inhibitory Concentration. Journal of Infectious Diseases. https://doi.org/10.1093/infdis/155.1.93
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
