{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:10:41Z","timestamp":1789726241566,"version":"4.0.1"},"reference-count":16,"publisher":"The Pediatric Pharmacy Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:sec>\n          <jats:title>OBJECTIVE<\/jats:title>\n          <jats:p>Aminoglycosides are frequently used for empiric and definitive treatment of cystic fibrosis (CF) pulmonary exacerbations. Various methods have been described for aminoglycoside therapeutic drug monitoring. The objective of this study is to evaluate the effect of patient-specific pharmacokinetic calculations for aminoglycosides used to treat CF pulmonary exacerbations.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>METHODS<\/jats:title>\n          <jats:p>Ambidirectional cohort study of patients admitted to a children's hospital from June 1, 2018, through February 28, 2019, and June 1, 2019, through February 8, 2021. The primary outcome was the occurrence of dosing changes after analysis of initial serum concentrations in either group. Secondary outcomes included occurrence of nephrotoxicity, duration of antibiotics, and length of stay.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>RESULTS<\/jats:title>\n          <jats:p>Twenty-four patients (75%) in the intervention group versus zero in the control group required dosing adjustments after initial analysis of serum concentrations were completed (p &lt; 0.001). There was not a statistically significant between-group difference for duration of antibiotics in days (median, 14 vs 13.5; Z, 1.07; p = 0.29) or length of stay (median, 11 vs 11; Z, \u22120.31; p = 0.76). There was also not a statistically significant between-group difference in forced expiratory volume in one second (FEV<jats:sub>1<\/jats:sub>) change from admission to discharge (11.4% vs 13.9%; <jats:italic>t<\/jats:italic>, 0.61; Degrees of Freedom, 39; p = 0.55). Two patients (6.25%) in the intervention group experienced nephrotoxicity compared with zero patients in the control group (risk difference, 6.25%; 95% CI, \u22122.14 to 14.64; number needed to harm, 16).<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>CONCLUSIONS<\/jats:title>\n          <jats:p>Patient-specific pharmacokinetic monitoring led to significantly more dosing changes and was associated with similar patient outcomes as trough-only monitoring. Further studies are needed to identify methods to optimize aminoglycoside dosing and monitoring for these patients with the goal of reducing toxicities while maximizing efficacy.<\/jats:p>\n        <\/jats:sec>","DOI":"10.5863\/1551-6776-27.7.655","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T22:24:24Z","timestamp":1664231064000},"page":"655-662","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Patient-Specific Aminoglycoside Monitoring for Treatment of Pediatric Cystic Fibrosis Pulmonary Exacerbations"],"prefix":"10.5863","volume":"27","author":[{"given":"Brianna","family":"Hemmann","sequence":"first","affiliation":[{"name":"Department of Pharmacy (BH), Cincinnati Children's Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Woods","sequence":"additional","affiliation":[{"name":"Departments of Pharmacy (EW, TM, CP, MS), Wake Forest Baptist Health Brenner Children's Hospital, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Makhlouf","sequence":"additional","affiliation":[{"name":"Departments of Pharmacy (EW, TM, CP, MS), Wake Forest Baptist Health Brenner Children's Hospital, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Gillette","sequence":"additional","affiliation":[{"name":"Department of Physician Assistant Studies (CG, CP), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Perry","sequence":"additional","affiliation":[{"name":"Departments of Pharmacy (EW, TM, CP, MS), Wake Forest Baptist Health Brenner Children's Hospital, Winston-Salem, NC"},{"name":"Department of Physician Assistant Studies (CG, CP), Wake Forest School of Medicine, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Departments of Pharmacy (EW, TM, CP, MS), Wake Forest Baptist Health Brenner Children's Hospital, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Hanes","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (HH), Wake Forest Baptist Health Brenner Children's Hospital, Winston-Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3883","reference":[{"issue":"12","key":"i2331-348X-27-7-655-b1","series-title":"Future Microbiol","first-page":"1901","article-title":"Management of Pseudomonas aeruginosa infection in cystic fibrosis patients using inhaled antibiotics with a focus on nebulized liposomal amikacin","volume":"10","year":"2015","unstructured":"Ehsan\n              Z,\n            \n            \n              Clancy\n              JP.\n            \n          \n          Management of Pseudomonas aeruginosa infection in cystic fibrosis patients using inhaled antibiotics with a focus on nebulized liposomal amikacin.\n\t\t\t\t\tFuture Microbiol.\n\t\t\t\t\t2015;10(12):1901\u20131912."},{"issue":"9","key":"i2331-348X-27-7-655-b2","series-title":"Am J Respir Crit Care Med","first-page":"802","article-title":"Cystic fibrosis pulmonary guidelines: treatment of pulmonary exacerbations","volume":"180","year":"2009","unstructured":"Flume\n              PA,\n            \n            \n              Mogayzel\n              PJ\n              Jr,\n            \n            \n              Robinson\n              KA,\n            \n          \n          .\n\t\t\t\t\tCystic fibrosis pulmonary guidelines: treatment of pulmonary exacerbations.\n\t\t\t\t\tAm J Respir Crit Care Med.\n\t\t\t\t\t2009;180(9):802\u2013808."},{"key":"i2331-348X-27-7-655-b3","series-title":"Cochrane Database Syst Rev","first-page":"CD002009","article-title":"Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis","volume":"3","year":"2006","unstructured":"Smyth\n              AR,\n            \n            \n              Tan\n              KH.\n            \n          \n          Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis.\n\t\t\t\t\tCochrane Database Syst Rev.\n\t\t\t\t\t2006;3:CD002009."},{"key":"i2331-348X-27-7-655-b4","series-title":"Cochrane Database Syst Rev","first-page":"CD002009","article-title":"Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis","volume":"3","year":"2017","unstructured":"Smyth\n              AR,\n            \n            \n              Bhatt\n              J,\n            \n            \n              Nevitt\n              SJ.\n            \n          \n          Once-daily versus multiple-daily dosing with intravenous aminoglycosides for cystic fibrosis.\n\t\t\t\t\tCochrane Database Syst Rev.\n\t\t\t\t\t2017;3:CD002009."},{"issue":"9459","key":"i2331-348X-27-7-655-b5","series-title":"Lancet","first-page":"573","article-title":"Once versus three-times daily regimens of tobramycin treatment for pulmonary exacerbations of cystic fibrosis\u2014the TOPIC study: a randomised controlled trial","volume":"365","year":"2005","unstructured":"Smyth\n              A,\n            \n            \n              Tan\n              KH-V,\n            \n            \n              Hyman-Taylor\n              P,\n            \n          \n          .\n\t\t\t\t\tOnce versus three-times daily regimens of tobramycin treatment for pulmonary exacerbations of cystic fibrosis\u2014the TOPIC study: a randomised controlled trial.\n\t\t\t\t\tLancet.\n\t\t\t\t\t2005;365(9459):573\u2013578."},{"issue":"2","key":"i2331-348X-27-7-655-b6","series-title":"Clin Pharmacokinet","first-page":"89","article-title":"Once daily aminoglycoside therapy. Is it less toxic than multiple daily doses and how should it be monitored?","volume":"36","year":"1999","unstructured":"Barclay\n              ML,\n            \n            \n              Kirkpatrick\n              CM,\n            \n            \n              Begg\n              EJ.\n            \n          \n          Once daily aminoglycoside therapy. Is it less toxic than multiple daily doses and how should it be monitored?\n          \n            Clin Pharmacokinet\n          .\n\t\t\t\t\t1999;36(2):89\u201398."},{"issue":"1","key":"i2331-348X-27-7-655-b7","series-title":"Pharmacotherapy","first-page":"95","article-title":"Extended-interval once-daily dosing of aminoglycosides in adult and pediatric patients with cystic fibrosis","volume":"30","year":"2010","unstructured":"Prescott\n              WA\n              Jr,\n            \n            \n              Nagel\n              JL.\n            \n          \n          Extended-interval once-daily dosing of aminoglycosides in adult and pediatric patients with cystic fibrosis.\n\t\t\t\t\tPharmacotherapy.\n\t\t\t\t\t2010;30(1):95\u2013108."},{"issue":"4","key":"i2331-348X-27-7-655-b8","series-title":"J Antimicrob Chemother","first-page":"822","article-title":"Once-daily tobramycin in cystic fibrosis: better for clinical outcome than thrice-daily tobramycin but more resistance development?","volume":"58","year":"2006","unstructured":"Burkhardt\n              O,\n            \n            \n              Lehmann\n              C,\n            \n            \n              Madabushi\n              R,\n            \n          \n          .\n\t\t\t\t\tOnce-daily tobramycin in cystic fibrosis: better for clinical outcome than thrice-daily tobramycin but more resistance development?J Antimicrob Chemother.\n\t\t\t\t\t2006;58(4):822\u2013829."},{"key":"i2331-348X-27-7-655-b9","series-title":"Glob Pediatr Health","first-page":"1","article-title":"Extended-interval aminoglycoside use in cystic fibrosis exacerbation in children and young adults","volume":"3","year":"2016","unstructured":"Safi\n              KH,\n            \n            \n              Damiani\n              JM,\n            \n            \n              Sturza\n              J,\n            \n            \n              Nasr\n              SZ.\n            \n          \n          Extended-interval aminoglycoside use in cystic fibrosis exacerbation in children and young adults.\n\t\t\t\t\tGlob Pediatr Health.\n\t\t\t\t\t2016;3:1\u20137."},{"issue":"4","key":"i2331-348X-27-7-655-b10","series-title":"J Pediatr Pharmacol Ther","first-page":"262","article-title":"Developmental pharmacokinetics in pediatric populations","volume":"19","year":"2014","unstructured":"Lu\n              H,\n            \n            \n              Rosenbaum\n              S.\n            \n          \n          Developmental pharmacokinetics in pediatric populations.\n\t\t\t\t\tJ Pediatr Pharmacol Ther.\n\t\t\t\t\t2014;19(4):262\u2013276."},{"issue":"2","key":"i2331-348X-27-7-655-b11","series-title":"J Cystic Fibrosis","first-page":"125","article-title":"Therapeutic drug monitoring of once daily tobramycin in cystic fibrosis\u2014caution with trough concentrations","volume":"6","year":"2007","unstructured":"Coulthard\n              KP,\n            \n            \n              Peckham\n              DG,\n            \n            \n              Conway\n              SP,\n            \n          \n          .\n\t\t\t\t\tTherapeutic drug monitoring of once daily tobramycin in cystic fibrosis\u2014caution with trough concentrations.\n\t\t\t\t\tJ Cystic Fibrosis.\n\t\t\t\t\t2007;6(2):125\u2013130."},{"issue":"4","key":"i2331-348X-27-7-655-b12","series-title":"J Pediatr Pharmacol Ther","first-page":"262","article-title":"National survey of extended-interval aminoglycoside dosing in pediatric cystic fibrosis pulmonary exacerbations","volume":"16","year":"2011","unstructured":"Prescott\n              WA\n              Jr.\n            \n          \n          National survey of extended-interval aminoglycoside dosing in pediatric cystic fibrosis pulmonary exacerbations.\n\t\t\t\t\tJ Pediatr Pharmacol Ther.\n\t\t\t\t\t2011;16(4):262\u2013269."},{"issue":"3","key":"i2331-348X-27-7-655-b13","series-title":"Clin Pharmacokinet","first-page":"389","article-title":"Monitoring of tobramycin exposure: what is the best estimation method and sampling time for clinical practice?","volume":"58","year":"2019","unstructured":"Gao\n              Y,\n            \n            \n              Hennig\n              S,\n            \n            \n              Barras\n              M.\n            \n          \n          Monitoring of tobramycin exposure: what is the best estimation method and sampling time for clinical practice?\n          \n            Clin Pharmacokinet\n          .\n\t\t\t\t\t2019;58(3):389\u2013399."},{"issue":"3","key":"i2331-348X-27-7-655-b14","series-title":"J Pediatr Pharmacol Ther","first-page":"239","article-title":"Tobramycin and beta-lactam antibiotic use in cystic fibrosis exacerbations: a pharmacist approach","volume":"21","year":"2016","unstructured":"Zobell\n              JT,\n            \n            \n              Epps\n              K,\n            \n            \n              Kittell\n              F,\n            \n          \n          .\n\t\t\t\t\tTobramycin and beta-lactam antibiotic use in cystic fibrosis exacerbations: a pharmacist approach.\n\t\t\t\t\tJ Pediatr Pharmacol Ther.\n\t\t\t\t\t2016;21(3):239\u2013246."},{"issue":"1","key":"i2331-348X-27-7-655-b15","series-title":"Int J Pharm Pract","first-page":"75","article-title":"Estimating drug-free period using a graphical method: an alternative way to monitor extended-interval dosing of gentamicin therapy","volume":"25","year":"2017","unstructured":"Ab Rahman\n              AF,\n            \n            \n              Md Sahak\n              N,\n            \n            \n              Ali\n              AM.\n            \n          \n          Estimating drug-free period using a graphical method: an alternative way to monitor extended-interval dosing of gentamicin therapy.\n\t\t\t\t\tInt J Pharm Pract.\n\t\t\t\t\t2017;25(1):75\u201380."},{"issue":"7","key":"i2331-348X-27-7-655-b16","series-title":"Am J Respir Crit Care Med","first-page":"680","article-title":"Cystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health","volume":"187","year":"2013","unstructured":"Mogayzel\n              PJ,\n            \n            \n              Naureckas\n              ET,\n            \n            \n              Robinson\n              KA,\n            \n          \n          .\n\t\t\t\t\tCystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health.\n\t\t\t\t\tAm J Respir Crit Care Med.\n\t\t\t\t\t2013;187(7):680\u2013689."}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/27\/7\/article-p655.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/27\/7\/655\/3124301\/i2331-348x-27-7-655.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/27\/7\/article-p655.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/27\/7\/article-p655.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:37:48Z","timestamp":1747355868000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/27\/7\/article-p655.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":16,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-27.7.655","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"value":"2331-348X","type":"electronic"},{"value":"1551-6776","type":"print"}],"subject":[],"published":{"date-parts":[[2022]]}}}