Abstract
A number of randomised studies indicate that a single high dose of aminoglycoside every 24 h may be more efficient and less toxic than the same dose divided into multiple daily doses.
In the meta-analysis of 16 studies described here, which included more than 1200 patients, the relative chance (i.e. the relative risk, RR) of cure of the single-dose regime compared with the multiple-dose regime was 1.027, indicating that the single daily dose regime had a 2.7 % higher cure rate (NS). The RR of avoiding nephrotoxicity was 1.001 (NS) and the RR of avoiding ototoxicity was 1.001 (NS).
It is concluded that there is no difference concerning efficacy and safety between single-dose and multiple-dose regimes for administration of aminoglycosides.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gilman AG, Roll TN, Nies AS, Taylor P (1990) Goodman and Gilman's The pharmacological basis of therapeutics, 8th edn. Pergamon Press, New York
Gilbert DN (1991) Minireview. Once-daily aminoglycoside therapy. Antimicrob Agents Chemother 35: 399–405
Nordström L, Lerner SA (1991) Single daily dose therapy with aminoglycosides. J Hosp Infect 18 [Suppl A]: 117–129
Prins JM, Büller HR, Kuijper EJ, Tange RA, Speelman P (1993) Once versus thrice daily gentamicin in patients with serious infections. Lancet 341: 335–339
Maller R, Isaksson B, Nilsson L, Sörén L (1988) A study of amikacin given once versus twice daily in serious infections. J Antimicrob Chemother 22: 75–79
Sturm AW (1989) Netilmicin in the treatment of gram-negative bacteremia: single daily versus multiple daily dosage. J Infect Dis 159: 931–937
Fan ST, Lau WY, Teoh-Chan CH, Lau KF, Mauracher EH (1988) Once daily administration of netilmicin compared with thrice daily, both in combination with metronidazole, in gang-renous and perforated appendicitis. J Antimicrob Chemother 22: 69–74
Nordström L, Ringberg H, Cronberg S, Tjernström O, Walder M (1990) Does administration of an aminoglycoside in a single daily dose affect its efficacy and toxicity. J Antimicrob Chemother 25: 159–173
Tulkens PM (1991) Efficacy and safety of aminoglycosides once-a-day: experimental and clinical data. Scand J Infect Dis [Suppl] 74: 249–257
Hollender LF, Bahnini J, Manzini ND, Lau WY, Fan ST, Hermansyur K, Benny P, Husni AN, Sutjipto, Lorber RR (1989) A multicentric study of netilmicin once daily versus thrice daily in patients with appendicitis and other intraabdominal infections. J Antimicrob Chemother 23: 773–783
Cohen B, Saginur R, Clecner B, Mendelson J, Kavalec E (1985) Double-blind comparative trial of once-vs twice-daily netilmicin therapy in severe acute urinary tract infections. Curr Ther Res 38: 880–884
Mauracher EH, Lau WY, Kartowisastro H, Ong KH, Genato VX, Limson B, Yusi GM, Liu CY, Suwangool P (1989) Comparison of once-daily and thrice-daily netilmicin regimens in serious systemic infections: a multicentre study in six Asian countries. Clin Ther 11: 604–613
Giamarellou H, Yiallouros K, Petrikkos G, Moschovakis E, Vavouraki E, Voutsinas D, Sfikakis P (1991) Comparative kinetics and efficacy of amikacin administered once or twice daily in the treatment of systemic Gram-negative infections. J Antimicrob Chemother 27 [Suppl C]: 73–79
Maller R, Ahrne H, Eilard T, Eriksson I, Lausen I, The Scandinavian Amikacin Once-Daily Study Group (1991) Efficacy and safety of amikacin in systemic infections when given as a single daily dose or in two divided doses. J Antimicrob Chemother 27 [Suppl C]: 121–128
Hansen M, Achen F, Carstensen C, Coolidge J, Dahlager J, Frimodt-Møller N, Kjaersgaard E, Larsen H, Wilkenschildt M, Zador G, Hippe E (1988) Once- versus thrice-daily dosing of netilmicin in febrile immunocompromised patients: a randomized, controlled study of efficacy and safety. J Drug Dev 1 [Suppl 3]: 119–124
DeVries PJ, Verkooyen RP, Leguit P, Verbrugh HA (1990) Prospective randomized study of once-daily versus thrice-daily netilmicin regimens in patients with intraabdominal infections. Eur J Clin Microbiol Infect Dis 9: 161–168
Klastersky J, Prevost JM, Meunier-Carpentier F, Daneau D, Gerard M (1977) Comparative trial of single-dose versus twice-daily sisomicin in bacteriuric patients. J Clin Pharmacol 17: 520–528
Ter Braak EW, Vries PJ de, Bouter KP, Vegt SG van der, Dorrestein GC, Nortier JW, Dijk A van, Verkooyen RP, Verbrugh HA (1990) Once-daily dosing regimen for aminoglycoside plus β-lactam combination therapy of serious bacterial infections: comparative trial with netilmicin plus ceftriaxone. Am J Med 89: 58–66
Labovitz E, Levison ME, Kaye D (1974) Single-dose daily gentamicin therapy in urinary tract infection. Antimicrob Agents Chemother 6: 465–470
Prins JM, Speelman P, Kuijper EJ, Büller HR, Tange RA (1992) Once versus thrice daily administration of gentamicin in patients with serious infections — a randomized study. International Conference on Antimicrobial Agents and Chemotherapy, June 1992, Montreal, Canada; abstract 1591
Eddy DM, Hasselblad V, Schachter R (1992) Meta-analysis by the confidence profile method. The statistical synthesis of evidence. Academic Press, Boston
Rosenthal R (1986) Meta-analytic procedures for social research. Sage Publications, Beverly Hills
Spiegel MR (1975) Theory and problems of probability and statistics. Schaumis outline series. McGraw-Hill, New York
Bailar III JC, Mosteller F (eds) t(1992) Medical uses of statistics, 2nd edn., NEJM Books, Boston
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Galløe, A.M., Graudal, N., Christensen, H.R. et al. Aminoglycosides: single or multiple daily dosing?. Eur J Clin Pharmacol 48, 39–43 (1995). https://doi.org/10.1007/BF00202170
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00202170