A meta-analysis of the relative efficacy and toxicity of single daily dosing versus multiple daily dosing of aminoglycosides

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 metaanalyses 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.