A Meta-Analysis of the Relative Efficacy and Toxicity of Single Daily Dosing Versus Multiple Daily Dosing of Aminoglycosides

Clin Infect Dis. 1997 May;24(5):796-809. doi: 10.1093/clinids/24.5.796.

Abstract

We performed a meta-analysis of the efficacy and toxicity of single daily dosing (SDD) vs. multiple daily dosing of aminoglycosides and summarized the results of the four previously published meta-analyses on this subject. Our analysis showed that the overall clinical response rate favored SDD therapy (mean difference, +3.06%; 95% confidence limit [CL], +0.17% to +5.95%; P = .04). However, we found no significant difference in the overall microbiological response rates (mean difference, +1.25%; 95% CL, -0.40% to +2.89%) or in the clinical response rates (mean difference, +0.62%; 95% CL, -2.48% to +3.71%) when patients who received adjunctive antimicrobial therapy were excluded from the analysis. No significant differences were found in the incidences of nephrotoxicity, ototoxicity, or vestibular toxicity; the summary differences in the rates of these toxicities were -0.18% (95% CL, -2.17% to +1.81%), +1.38% (95% CL, -0.99% to +3.75%), and -3.05% (95% CL, -10.69% to +4.59%), respectively. These results are similar to those of the previously published meta-analyses.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Aged
  • Aminoglycosides
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / pharmacokinetics
  • Bacterial Infections / drug therapy
  • Bacterial Infections / microbiology
  • Clinical Trials as Topic
  • Confidence Intervals
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Hearing Disorders / chemically induced*
  • Hearing Disorders / epidemiology
  • Humans
  • Incidence
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / epidemiology
  • MEDLINE
  • Microbial Sensitivity Tests
  • Middle Aged
  • Risk Factors
  • Treatment Outcome
  • United States

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents