Examen Integrado Farmacia Hospitalaria Practice Questions - Examen Integrado De Residencias De La Salud - Farmacia Hospitalaria (Argentina) Exam

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Which pharmacokinetic rationale supports extended-interval (once-daily) dosing of aminoglycosides (such as amikacin or gentamicin) over conventional multiple-daily dosing regimens in hospital practice?

Aminoglycosides exhibit time-dependent bactericidal activity requiring constant low serum concentrations Maximizing the Cmax/MIC ratio (>= 8–10) enhances concentration-dependent bacterial killing while the prolonged drug-free interval exploits the post-antibiotic effect (PAE) and minimizes renal cortical accumulation Once-daily dosing increases tubular secretion by renal P-glycoprotein, completely preventing ototoxicity Aminoglycosides undergo saturable hepatic first-pass metabolism that is bypassed by single daily intravenous boluses

Correct Answer:

Maximizing the Cmax/MIC ratio (>= 8–10) enhances concentration-dependent bacterial killing while the prolonged drug-free interval exploits the post-antibiotic effect (PAE) and minimizes renal cortical accumulation

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