High-dose aminoglycoside therapy (6–8 mg/kg/d) in an intravenous drug abuser with Pseudomonas aeruginosa endocarditis is described. The dose of tobramycin was adjusted to achieve peak serum concentrations of 15–20 μg/ml and trough concentrations of 〈 2 μg/ml. Significant drug-induced toxicities were not observed. Treatment of P. aeruginosa endocarditis with high-dose aminoglycosides may be appropriate and beneficial in selected patients.
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