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Related Experiment Videos

[Dosing aminoglycosides once a day]

J Blaser1

  • 1Department für Innere Medizin, Universitätsspital Zürich.

Schweizerische Medizinische Wochenschrift. Supplementum
|January 1, 1996
PubMed
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Once-daily aminoglycoside dosing, including amikacin, netilmicin, and gentamicin, improves clinical and bacteriological efficacy compared to multiple daily doses. This dosing strategy also offers potential cost savings and reduced toxicity.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Aminoglycosides traditionally administered in multiple daily doses.
  • Animal studies suggest reduced nephrotoxicity with extended dosing intervals.
  • In vitro and in vivo data indicate potential for increased efficacy with once-daily aminoglycoside administration.

Purpose of the Study:

  • To compare the efficacy and safety of once-daily versus multiple daily dosing regimens of aminoglycosides.
  • To evaluate clinical and bacteriological outcomes, as well as nephrotoxicity and ototoxicity.
  • To assess the economic implications of different aminoglycoside dosing strategies.

Main Methods:

  • Meta-analysis of 24 randomized clinical trials.
  • Inclusion of 3181 patients receiving amikacin, netilmicin, or gentamicin.

Related Experiment Videos

  • Comparison of once-daily versus multiple daily dosing regimens.

    • Main Results:

    • Once-daily dosing demonstrated significantly higher clinical efficacy (89.5% vs. 84.7%, p < 0.001).
    • Bacteriological efficacy was also significantly improved with once-daily administration (88.6% vs. 83.4%, p < 0.01).
    • Trends towards reduced nephrotoxicity (4.5% vs. 5.5%) and ototoxicity (4.2% vs. 5.8%) were observed with once-daily dosing, though not statistically significant.

    Conclusions:

    • Once-daily administration of amikacin, netilmicin, and gentamicin is clinically and bacteriologically superior to multiple daily dosing.
    • Once-daily aminoglycoside therapy may lead to cost reductions due to fewer infusions and reduced monitoring needs.
    • The findings support the adoption of once-daily aminoglycoside dosing regimens in clinical practice.