[Dosing aminoglycosides once a day]
- PMID: 8677418
[Dosing aminoglycosides once a day]
Abstract
In the past few decades aminoglycosides have usually been administered as multiple daily dosing regimens. However, animal experiments have shown that nephrotoxicity can be reduced if, with the same total daily dose, the dosing interval is spread out. Further, several in-vitro and in-vivo studies suggest that once-daily dosing may be more effective. In 24 randomized, clinical trials, once- vs. multiple daily dosing regimens of amikacin, netilmicin and gentamicin have been compared in a total of 3181 patients. An analysis of these studies revealed significant advantages in favour of once-daily dosing for both clinical efficacy (89.5% vs. 84.7%, p < 0.001) and bacteriological efficacy (88.6% vs. 83.4%, p < 0.01). In addition, improved but not statistically significant results were obtained with once-daily dosing with regard to nephrotoxicity (4.5% for once-daily vs. 5.5% for multiple daily dosing) and ototoxicity (4.2% vs. 5.8%). Furthermore, once-daily dosing is cheaper, as less infusions are required and the expense of monitoring serum levels can be reduced. In conclusion, amikacin, netilmicin and gentamicin can be administered once a day.
Similar articles
-
[Daily single-dose aminoglycoside administration. Therapeutic and economic benefits].Ugeskr Laeger. 1993 May 10;155(19):1436-41. Ugeskr Laeger. 1993. PMID: 8316969 Review. Danish.
-
Efficacy and safety of aminoglycosides once-a-day: experimental and clinical data.Scand J Infect Dis Suppl. 1990;74:249-57. Scand J Infect Dis Suppl. 1990. PMID: 2097713 Review.
-
[Once-daily dosage of aminoglycosides--a therapeutic simplification and an economical benefit].Tidsskr Nor Laegeforen. 1999 Sep 10;119(21):3152-6. Tidsskr Nor Laegeforen. 1999. PMID: 10522483 Review. Norwegian.
-
The evolution of aminoglycoside therapy: a single daily dose.Am Fam Physician. 1996 Apr;53(5):1782-6. Am Fam Physician. 1996. PMID: 8623702 Review.
-
A prospective comparative study of gentamicin- and amikacin-induced nephrotoxicity in patients with normal baseline renal function.Fundam Clin Pharmacol. 2009 Aug;23(4):515-20. doi: 10.1111/j.1472-8206.2009.00702.x. Fundam Clin Pharmacol. 2009. PMID: 19709328 Clinical Trial.
Cited by
-
Pharmacokinetic changes and dosing modification of aminoglycosides in critically ill obese patients: a literature review.J Clin Med Res. 2014 Aug;6(4):227-33. doi: 10.14740/jocmr1858w. Epub 2014 May 22. J Clin Med Res. 2014. PMID: 24883145 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Medical
Miscellaneous