Comparison of two dosing regimens of aminoglycosides for the development of nephrotoxicity: once versus multiple daily dosing / 대한내과학회지

ABSTRACT

BACKGROUND: Aminoglycosides are useful for the treatment of aerobic gram-negative infections, and this is despite the narrow therapeutic index and the potential nephrotoxicity and ototoxicity. Once daily dosing of aminoglycosides has recently been suggested as an alternative method to multiple daily dosing. We compared the two dosing regimens of aminoglycosides for the development of nephrotoxicity. METHODS: This study was conducted as part of an ongoing quality improvement program. For the administration of aminoglycosides in adult patients with suspected or documented gram-negative infection, multiple daily dosing was used until April 2005 and thereafter once daily dosing was recommended. RESULTS: A total of 85 patients who received aminoglycoside for more than 3 days from March to August 2005 were available for analysis (40 in the once daily dosing group and 45 in the multiple daily dosing group). The mean duration of administration was 7.7 (range 3-19) days in the once daily dosing group and 8.0 (range 3-31) days in the multiple daily dosing group (p=0.83). Aminoglycoside-associated nephrotoxicity was observed in a patient in the once daily dosing group (2.5% vs 0%, respectively, p=0.48). CONCLUSIONS: No significant difference in the development of nephrotoxicity was found between the two dosing regimens for aminoglycosides, but this finding had low statistical power. This may be due to underdosing of aminoglycosides in the multiple daily dosing group.