Society of Infectious Diseases Pharmacists

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In the midst of many changes surrounding aminoglycosides over the past several years, clinicians may be left wondering if these agents still have a role in modern clinical practice. This article summarizes changes impacting aminoglycosides, discusses where these agents may still have a role in the context of gram-negative infections, and explores future areas of study.

Intravenous (IV) push is an attractive option to administer antimicrobial therapy to patients in an efficient and effective manner in a variety of clinical settings. While many advantages to IV push administration exist, clinicians should be mindful of available literature regarding safety profiles, pharmacokinetic/pharmacodynamic characteristics, and clinical data for IV push antimicrobial administration prior to utilizing it in specific patient populations.

Obesity significantly impacts the pharmacokinetics (PK) of antifungal drugs like echinocandins, including volume of distribution (Vd) and clearance. However, despite these PK differences, current clinical evidence generally does not support the need for universal dose adjustments in obese patients. Clinicians should consider personalized dosing based on patient characteristics, infection severity, and specific drug properties due to echinocandins' favorable safety profiles.

Long-acting lipoglycopeptides (LGPs) like dalbavancin, oritavancin, and telavancin were developed with extended half-lives, initially targeting acute bacterial skin and skin structure infections (ABSSSIs). However, recent studies have explored their potential in treating other infections, including infective endocarditis (IE), bone and joint infections (BJIs), and bloodstream infections (BSIs), offering an alternative to standard care and outpatient antimicrobial therapy.