Aminoglycoside pharmacokinetics: volume of distribution in specific adult patient subgroups

OBJECTIVE: To review the published clinical studies reporting volume of distribution for aminoglycosides in patient population subgroups. Controversies in methods used are discussed. DATA SOURCES: National Library of Medicine Medlars, searched using MEDLINE. STUDY SELECTION: Published articles primarily relating to pharmacokinetic properties of aminoglycosides in specific adult patient subgroups published within the past 20 years were included. Pediatric studies were excluded. DATA EXTRACTION: The methodology, assay technique, and results from clinical studies reporting aminoglycoside volume of distribution were evaluated. DATA SYNTHESIS: Clinical studies reporting aminoglycoside volume of distribution subgroups, including the methods by which their results were derived, are tabulated. CONCLUSIONS: The expected aminoglycoside volume of distribution can vary, depending on a patient's clinical presentation. Data presented will allow a more refined initial estimation of volumes of distribution, which may facilitate the achievement of desired aminoglycoside serum concentrations.