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The use of pulse dosing of aminoglycosides in neutropenic patients has yet
to be investigated in humans. Studies on neutropenic rats suggest that the
"postantibiotic effect" may be considerably shorter in neutropenia. The
implication is that with pulse dosing neutropenic pts would be "unprotected"
during the terminal portion of the dosing interval. These findings led to
the notion that neutropenic pts should be excluded from ODA dosing programs.
To date I know of no clinical study that addressed this issue specifically.
However, it is very likely that at least one is going on now. By the way,
these same formal dosing programs exclude pts with endocaditis and all
instances in which the aminoglycoside is used for its synergistic effect
together with a beta-lactam.
Nasr Anaizi, PhD, RPh
Univ. of Rochester Medical Center
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