SINGLE DAILY DOSING OF AMINOGLYCOSIDES IN IMMUNOCOMPROMISED ADULTS - A SYSTEMATIC REVIEW

We examined the efficacy and toxicity of single daily dosing (SDD) of aminoglycosides for febrile, immunocompromised adults by systematicall y reviewing four randomized, controlled trials of SDD vs. standard dos ing regimens. We assessed the methodological quality of each study and extracted data pertaining to efficacy and toxicity outcomes. Pooled r isk ratios for the efficacy outcomes were bacteriologic cure, 1.00 (95 % confidence interval [CI], 0.86-1.16); clinical cure, 0.97 (95% CI, 0 .91-1.05); and mortality, 0.93 (95% CI, 0.62-1.41). The pooled nephrot oxicity risk ratio was 0.78 (95% CI, 0.31-1.94). Only one study assess ed ototoxicity. Although our study was limited by the small number of trials available for review, the results suggest that SDD of aminoglyc osides may be efficacious for febrile, immunocompromised patients. Add itional studies are necessary for more precise quantification of the m ortality and toxicity risk ratios.