NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

What is the recommended dosing strategy for aminoglycosides, quinolones, and daptomycin to achieve their therapeutic goal?

1. Shorter dosing interval

2. Variable

3. Large dose, long interval

4. Extended for continuous infusions

The correct answer is: Large dose, long interval

The recommended dosing strategy for aminoglycosides, quinolones, and daptomycin to achieve their therapeutic goal is to administer a large dose with a long dosing interval. This dosing strategy is known as 'large dose, long interval.' Aminoglycosides, such as gentamicin and amikacin, exhibit concentration-dependent killing. Administering a large dose with a prolonged dosing interval helps maximize the peak concentration (Cmax) relative to the minimum inhibitory concentration (MIC), enhancing their bactericidal activity while minimizing the risk of toxicity. Quinolones, like ciprofloxacin and levofloxacin, also benefit from a large initial dose to rapidly achieve therapeutic concentrations and optimize bacterial killing. Similarly, daptomycin, a lipopeptide antibiotic, displays concentration-dependent bactericidal activity. Providing a large dose with an extended dosing interval helps maintain concentrations above the minimum inhibitory concentration (MIC), ensuring optimal efficacy. Therefore, the most effective dosing strategy for these antimicrobial agents is a large dose with a long dosing interval to achieve the desired therapeutic outcome.