aminoglycosides in burn patients

Q: Burn patients when receiving aminoglycosides, may require ___________ maintenance dose? (select one)

A) higher

B) lower

Answer: A

Gentamicin and Tobramycin are frequently used in ICUs. Burn patients have larger volumes of distribution, and may require up to 7 to 8 mg/kg per day to attain therapeutic serum concentrations. These are usually given in divided doses. 

Clinically this is of importance as serum concentration monitoring and individualized dosing highly correlates with survival in burn patients.

#pharmacology

References:

1. Zaske DE. Aminoglycosides. In: Applied Pharmacokinetics, 3rd Ed, William EE, Schentag EJ, Jusko WJ (Eds), Applied Therapeutics Inc, Vancouver, WA 1994.

2. Hollingsed TC, Harper DJ, Jennings JP, Morris SE, Saffle JR. Aminoglycoside dosing in burn patients using first-dose pharmacokinetics. J Trauma. 1993 Sep;35(3):394-8. PMID: 8371297.