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Once daily versus multiple daily dosing with intravenous aminoglycosides for cystic fibrosis

K Tan1, H Bunn

  • 1Child Health, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham, UK, NG5 1PB. Kelvin.Tan@nottingham.ac.uk

The Cochrane Database of Systematic Reviews
|October 18, 2000
PubMed
Abstract

Insights

Once-daily aminoglycoside antibiotics are as effective and safe as multiple daily doses for cystic fibrosis pulmonary exacerbations, but larger trials are needed. This finding impacts antibiotic dosing strategies for Pseudomonas aeruginosa infections in CF patients.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Pharmacology

Background:

  • Cystic fibrosis (CF) patients often have chronic Pseudomonas aeruginosa colonization.
  • Pulmonary exacerbations in CF commonly require intravenous aminoglycoside antibiotics.
  • Aminoglycoside properties suggest potential for less frequent, higher-dose administration.

Purpose of the Study:

  • To evaluate the efficacy and safety of once-daily versus multiple-daily intravenous aminoglycoside dosing.
  • To assess antibiotic treatment strategies for CF pulmonary exacerbations.

Main Methods:

  • Systematic review of randomized controlled trials comparing aminoglycoside dosing regimens.
  • Searched specialized CF trials registers and electronic databases (search up to February 2000).
  • Independent data extraction and quality assessment by reviewers.

Main Results:

  • Two trials with 70 patients compared once-daily with thrice-daily aminoglycoside dosing.
  • No significant differences observed in efficacy (FEV1, FVC, nutritional status) or toxicity (ototoxicity, nephrotoxicity).

Conclusions:

  • Current evidence suggests similar efficacy and safety between once-daily and multiple-daily aminoglycoside dosing for CF pulmonary exacerbations.
  • Small patient numbers necessitate caution; larger, well-powered trials are required.
  • Highlights the need for robust research into optimal aminoglycoside dosing in CF.

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