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Review
. 2025 Aug;48(4):133-138.
doi: 10.18773/austprescr.2025.038.

Aminoglycosides: an update on indications, dosing and monitoring

Hazel Moore  1   2   3   4   5   6 , Daniel Yeoh  1   2   3   4   5   6 , Carly Hughes  1   2   3   4   5   6 , Edward Raby  1   2   3   4   5   6 , Indy Sandaradura  1   2   3   4   5   6
Affiliations
Review

Aminoglycosides: an update on indications, dosing and monitoring

Hazel Moore et al. Aust Prescr. 2025 Aug.

Abstract

Aminoglycosides (gentamicin, tobramycin and amikacin) are highly effective parenteral drugs commonly used as initial empirical therapy of serious Gram-negative infections. They have rapid bactericidal activity and relatively low rates of resistance in Australia compared with other antibiotics used to manage Gram-negative infections. Therapeutic Guidelines: Antibiotic was updated in March 2025 and provides new guidance on the role of aminoglycosides, optimised dosing, and drug selection. The guidelines now recommend that dosing in adults is based on lean body weight, and provide calculators to assist with dose calculations. Therapeutic drug monitoring is required when aminoglycoside therapy is expected to continue beyond 48 hours; monitoring the area under the aminoglycoside concentration-time curve is recommended in adults.

Keywords: amikacin; aminoglycosides; gentamicin; nephrotoxicity; therapeutic drug monitoring; tobramycin.

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Conflict of interest statement

Conflicts of interest: Hazel Moore is an employee of Therapeutic Guidelines Limited, the publisher of Australian Prescriber. Edward Raby received research funding from Merck Sharp and Dohme, and Merck and Co. Indy Sandaradura received research funding from Pfizer for the development of isavuconazole, linezolid, ceftaroline and ceftazidime+avibactam therapeutic drug monitoring assays for children. Indy is a co-investigator on studies funded by the Medical Research Future Fund aimed at treating antibiotic-resistant bacteria, and the NSW Government on evaluating pharmacist prescribing. Indy is an advisory committee member and examiner for the Royal College of Pathologists of Australasia, and an executive member of the Australian Committee for Antimicrobial Susceptibility Testing. All authors were members of the expert groups for Therapeutic Guidelines: Antibiotic version 17. Carly Hughes and Daniel Yeoh have no other conflicts of interest to declare.

References

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