Aminoglycosides’ dosing and monitoring practices in critically ill patients in Quebec hospitals

Abstract

Considering the aminoglycosides’ characteristics in terms of efficacy and toxicity, multiple dosing recommendations and nomograms have been suggested over several decades. The objective is to describe the dosing and monitoring practices of amikacin, gentamicin, and tobramycin in critically ill patients across health care institutions in the province of Quebec.This survey was developed with multiple-choices and short answers and targeted the lead pharmacist responsible of antimicrobial stewardship in each health care institution.Gentamicin and tobramycin dosing regimens were in-line with guidelines from different countries. Amikacin was not commonly used in Quebec. Therapeutic targets were generally consistent with the literature.Dosing adaptation were mostly done based on clinician judgment or with homemade software. Given the variability seen across practices in Quebec institutions, standardization and optimization of aminoglycosides therapeutic drug monitoring may be considered.