{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:11:38Z","timestamp":1790892698155,"version":"4.1.0"},"reference-count":38,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T00:00:00Z","timestamp":1314835200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Aminoglycosides are an important class of agents that are used in combination antimicrobial regimens to treat bacterial pathogens. Dosing of aminoglycosides is typically based on total body weight. However, the most appropriate alternative body size descriptor for dosing aminoglycosides at the extremes of weight (underweight and obese) is not known. Also, the predictive performance of newer formulas to assess kidney function, such as the modification of diet in renal disease (MDRD) and chronic kidney disease-epidemiology (CKD-EPI) equations compared to the Cockcroft-Gault equation to predict aminoglycoside clearance, is not known. We sought to examine dosing of aminoglycosides across the extremes of weight using a variety of formulas to assess kidney function. Pharmacokinetic data were obtained from a set of prospectively collected data (1982 to 2003) of 2,073 (53.5% male) adult patients that included 497 tobramycin- and 1,576 gentamicin-treated cases. The median (minimum, maximum) age, weight, and body mass index were 66 (18, 98) years, 70.0 (29.7, 206.7) kg, and 24.4 (11.3, 73.8) kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    , respectively. The percentage of underweight, normal-weight, overweight, and obese cases based on the World Health Organization classification were 8.8%, 45.5%, 26.5%, and 19.2%, respectively. The aminoglycoside volume of distribution was normalized to several alternative body size descriptors. Only lean body weight estimated by the method of S. Janmahasatian et al. (Clin. Pharmacokinet. 44:1051\u20131065, 2005) normalized the volume of distribution for both tobramycin and gentamicin across all weight strata, with the estimate being approximately 0.45 liter\/kg. Aminoglycoside dosing can be simplified across all weight strata with the use of lean body weight. The CKD-EPI equation best predicts aminoglycoside clearance.\n                  <\/jats:p>","DOI":"10.1128\/aac.00174-11","type":"journal-article","created":{"date-parts":[[2011,6,14]],"date-time":"2011-06-14T13:44:05Z","timestamp":1308059045000},"page":"4006-4011","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":74,"title":["Simplified Estimation of Aminoglycoside Pharmacokinetics in Underweight and Obese Adult Patients"],"prefix":"10.1128","volume":"55","author":[{"given":"Manjunath P.","family":"Pai","sequence":"first","affiliation":[{"name":"Albany College of Pharmacy and Health Sciences, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne N.","family":"Nafziger","sequence":"additional","affiliation":[{"name":"Bertino Consulting, Schenectady, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Joseph S.","family":"Bertino","sequence":"additional","affiliation":[{"name":"Bertino Consulting, Schenectady, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mib.2010.09.004"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00542215"},{"key":"e_1_3_2_4_2","unstructured":"B. Braun Medical Inc. 2007. Gentamicin sulfate in 0.9% sodium chloride for injection. B. Braun Medical Inc. Bethlehem PA."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000180580"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2010.11.006"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp080200"},{"key":"e_1_3_2_8_2","first-page":"650","article-title":"Gentamicin therapy","volume":"8","author":"Devine B. J.","year":"1974","unstructured":"DevineB. J. 1974. Gentamicin therapy. Drug Intell. Clin. Pharm. 8:650\u2013655.","journal-title":"Drug Intell. Clin. Pharm"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.2014"},{"key":"e_1_3_2_10_2","volume-title":"Clinical pharmacology. Draft guidance","author":"Food and Drug Administration","year":"2010","unstructured":"Food and Drug Administration. 2010. Pharmacokinetics in patients with impaired renal function\u2014study design, data analysis, and impact on dosing and labeling. Clinical pharmacology. Draft guidance. Food and Drug Administration, U.S. Department of Health and Human Services, Washington, DC."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2004.02157.x"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq108"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/cbic.200900779"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-200544100-00004"},{"key":"e_1_3_2_15_2","first-page":"62","article-title":"Estimation of creatinine clearance in malnourished patients","volume":"7","author":"Lau A. H.","year":"1988","unstructured":"LauA. H. BerkS. I. ProsserT. StonichT.. 1988. Estimation of creatinine clearance in malnourished patients. Clin. Pharm. 7:62\u201365.","journal-title":"Clin. 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National Kidney Disease Education Program Bethesda MD. http:\/\/www.nkdep.nih.gov\/professionals\/drug-dosing-information.htm."},{"key":"e_1_3_2_22_2","first-page":"1","article-title":"Mean body weight, height, and body mass index, United States 1960-2002","author":"Ogden C. L.","year":"2004","unstructured":"OgdenC. L. FryarC. D. CarrollM. D. FlegalK. M.. 2004. Mean body weight, height, and body mass index, United States 1960-2002. Adv. Data, p. 1\u201317.","journal-title":"Adv. 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