The evolution of aminoglycoside therapy: a single daily dose.

After five decades of clinical use, aminoglycosides continue to be important antibiotics in the management of gram-negative infections. However, antimicrobial therapy with gentamicin, tobramycin, amikacin and netilmicin has been complicated by the risk of nephrotoxicity and ototoxicity. Considerable research has been conducted to determine the optimal aminoglycoside dosing method that will produce maximum efficacy with minimal toxicity. Experimental data and clinical experience suggest that aminoglycoside regimens modified from standard dosing (every eight to 12 hours) to once-daily dosing may provide improved clinical outcomes, with reduced toxicity and cost of therapy. Gentamicin, tobramycin and netilmicin may be administered in single daily dosages ranging from 4 to 7 mg per kg, and amikacin may be given in a dosage of 15 to 20 mg per kg once daily.

Sexuality and aging. An overview.

To summarize our ramblings, we want to highlight the following points as you deal with the topic of sexuality and aging: 1. Sexuality, the mix of physical and relational behaviors that gives us both parenting and bonding, is lifelong, extending well beyond the reproductive years, and a normal factor in self-esteem and satisfaction. 2. Aged individuals need sexually and medically what people in general want and need, and the idea of an acceptable decline into a sexless state is insulting. 3. An immense amount of information is available to assist seniors in dealing with physical and emotional problems relating to sexuality, and much can be done by showing sensitivity and by breaking down the habits of concealing problems or attributing them to the demon of age. 4. In sexuality, as well as in all other areas, we need to recognize that older individuals will be present at society's table in increasing numbers and with increasing expectations, and it is up to society to make them welcome--now, because they include our parents, and in the future, because they will include ourselves.