Single daily dosing of aminoglycosides in immunocompromised adults: a systematic review.
We examined the efficacy and toxicity of single daily dosing (SDD) of aminoglycosides for febrile, immunocompromised adults by systematically reviewing four randomized, controlled trials of SDD vs. standard dosing regimens. We assessed the methodological quality of each study and extracted data pertaining to efficacy and toxicity outcomes. Pooled risk ratios for the efficacy outcomes were bacteriologic cure, 1.00 (95% confidence interval [CI], 0.86-1.16); clinical cure, 0.97 (95% CI, 0.91-1.05); and mortality, 0.93 (95% CI, 0.62-1.41). The pooled nephrotoxicity risk ratio was 0.78 (95% CI, 0.31-1.94). Only one study assessed ototoxicity. Although our study was limited by the small number of trials available for review, the results suggest that SDD of aminoglycosides may be efficacious for febrile, immunocompromised patients. Additional studies are necessary for more precise quantification of the mortality and toxicity risk ratios.
Hatala
R
R
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Dinh
T T
TT
Cook
D J
DJ
D000328:Adult; D000368:Aged; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D001424:Bacterial Infections / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006311:Hearing Disorders / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents