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

Abstract

BACKGROUND

Patients with cystic fibrosis, who are chronically colonised with the organism Pseudomonas aeruginosa, often require repeated courses of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations. The properties of aminoglycosides suggest that they could be given in higher concentrations less often.

OBJECTIVES

To assess the effectiveness and safety of once-daily versus multiple-daily dosing of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations in cystic fibrosis.

SEARCH STRATEGY

We searched the Cystic Fibrosis specialist trials register held at the Cochrane Cystic Fibrosis and Genetic Disorders Group's editorial base, which comprises references identified from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Date of the most recent search: February 2000.

SELECTION CRITERIA

All randomised controlled trials, whether published or unpublished, in which once-daily dosing of aminoglycosides has been compared with multiple-daily dosing in terms of efficacy and/or toxicity, in patients with cystic fibrosis.

DATA COLLECTION AND ANALYSIS

Both reviewers independently extracted data and assessed trial quality. Authors of one study were contacted to obtain missing information.

MAIN RESULTS

Two trials reporting results from a total of 70 patients were included in this review. Both trials compared once-daily dosing with thrice-daily dosing reporting data on Forced Expiratory Volume at one second (FEV1), Forced Vital Capacity (FVC), nutritional status and side effects. There was no significant difference in efficacy or in the incidence of ototoxicity and nephrotoxicity between treatment groups.

REVIEWER'S CONCLUSIONS

Despite a lack of difference between the two groups we feel that these results should be viewed with caution as the numbers of patients involved was small and lacks the power to detect a difference between the groups. This systematic review has highlighted the need for a well designed, adequately-powered, multicentre, randomised controlled trial assessing the efficacy of once-daily versus multiple-daily dosing of intravenous aminoglycosides for pulmonary exacerbations in cystic fibrosis.

Authors+Show Affiliations

Child Health, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham, UK, NG5 1PB. Kelvin.Tan@nottingham.ac.ukNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

11034740

Citation

Tan, K, and H Bunn. "Once Daily Versus Multiple Daily Dosing With Intravenous Aminoglycosides for Cystic Fibrosis." The Cochrane Database of Systematic Reviews, 2000, p. CD002009.
Tan K, Bunn H. Once daily versus multiple daily dosing with intravenous aminoglycosides for cystic fibrosis. Cochrane Database Syst Rev. 2000.
Tan, K., & Bunn, H. (2000). Once daily versus multiple daily dosing with intravenous aminoglycosides for cystic fibrosis. The Cochrane Database of Systematic Reviews, (4), CD002009.
Tan K, Bunn H. Once Daily Versus Multiple Daily Dosing With Intravenous Aminoglycosides for Cystic Fibrosis. Cochrane Database Syst Rev. 2000;(4)CD002009. PubMed PMID: 11034740.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Once daily versus multiple daily dosing with intravenous aminoglycosides for cystic fibrosis. AU - Tan,K, AU - Bunn,H, PY - 2000/10/18/pubmed PY - 2001/8/3/medline PY - 2000/10/18/entrez SP - CD002009 EP - CD002009 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 4 N2 - BACKGROUND: Patients with cystic fibrosis, who are chronically colonised with the organism Pseudomonas aeruginosa, often require repeated courses of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations. The properties of aminoglycosides suggest that they could be given in higher concentrations less often. OBJECTIVES: To assess the effectiveness and safety of once-daily versus multiple-daily dosing of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations in cystic fibrosis. SEARCH STRATEGY: We searched the Cystic Fibrosis specialist trials register held at the Cochrane Cystic Fibrosis and Genetic Disorders Group's editorial base, which comprises references identified from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Date of the most recent search: February 2000. SELECTION CRITERIA: All randomised controlled trials, whether published or unpublished, in which once-daily dosing of aminoglycosides has been compared with multiple-daily dosing in terms of efficacy and/or toxicity, in patients with cystic fibrosis. DATA COLLECTION AND ANALYSIS: Both reviewers independently extracted data and assessed trial quality. Authors of one study were contacted to obtain missing information. MAIN RESULTS: Two trials reporting results from a total of 70 patients were included in this review. Both trials compared once-daily dosing with thrice-daily dosing reporting data on Forced Expiratory Volume at one second (FEV1), Forced Vital Capacity (FVC), nutritional status and side effects. There was no significant difference in efficacy or in the incidence of ototoxicity and nephrotoxicity between treatment groups. REVIEWER'S CONCLUSIONS: Despite a lack of difference between the two groups we feel that these results should be viewed with caution as the numbers of patients involved was small and lacks the power to detect a difference between the groups. This systematic review has highlighted the need for a well designed, adequately-powered, multicentre, randomised controlled trial assessing the efficacy of once-daily versus multiple-daily dosing of intravenous aminoglycosides for pulmonary exacerbations in cystic fibrosis. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/11034740/Once_daily_versus_multiple_daily_dosing_with_intravenous_aminoglycosides_for_cystic_fibrosis_ L2 - https://doi.org/10.1002/14651858.CD002009 DB - PRIME DP - Unbound Medicine ER -