How is efficacy ensured?

In order to be confident of effective treatment with aminoglycosides, reference groups, such as the European Committee on Antimicrobial Susceptibility Testing (EUCAST), define and regularly review the concentration of antimicrobial at which infection by a particular bacterial isolate is likely to be treatable. This is known as the ‘breakpoint’.

In 2020, EUCAST produced a guidance document on the use of revised breakpoints for aminoglycosides, suggesting that increased doses may be needed to ensure effective dosing, which is available under downloads below.

This has led healthcare facilities to review the dosages of aminoglycosides used, and in some cases, they have increased. When using combined therapy, they noted that ‘When using aminoglycosides in combination therapy with other antimicrobial agents, the evidence for successful use of lower doses is unclear; normally the goal in combination therapy is for each agent to be administered to achieve optimal drug exposure’. You can recap on the use of aminoglycoside combination therapy in step 1.11.

Click next to move on to the next activity where you will learn about aminoglycoside dosing strategies and how to calculate appropriate doses.