Aminoglycosides in the Intensive Care Unit: What Is New in Population PK Modeling?

Background: Although aminoglycosides are often used as treatment for Gram-negative infections, optimal dosing regimens remain unclear, especially in ICU patients. This is due to a large between- and within-subject variability the aminoglycoside pharmacokinetics this population. Objective: review provides comprehensive data on of patients hospitalized by summarizing all published PopPK models amikacin, gentamicin, tobramycin. The objective was determine presence consensus structural model used, significant covariates included, therapeutic targets considered during regimen simulations. Method: A literature search conducted Medline/PubMed database, using terms: ‘amikacin’, ‘gentamicin’, ‘tobramycin’, ‘pharmacokinetic(s)’, ‘nonlinear mixed effect’, ‘population’, ‘intensive care’, ‘critically ill’. Results: Nineteen articles were retained where tobramycin described six, 11, five models, respectively. two-compartment describe amikacin pharmacokinetics, whereas one-compartment majorly gentamicin pharmacokinetics. most recurrent renal clearance bodyweight. Across aminoglycosides, mean interindividual volume distribution 41.6% 22.0%, common an each not reached. Conclusions: showed developed from 2015 until now, past decades. Despite growing challenges external evaluation, latter should be more development. Further research including new covariates, additional simulated regimens, validation better understand