Tan K, Bunn H
Child Health, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham, UK, NG5 1PB.
Cochrane Database Syst Rev. 2000(4):CD002009. doi: 10.1002/14651858.CD002009.
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.
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.
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.
All randomised controlled trials, whether published or unpublished, in which once-daily dosing of aminoglycosides has been compared with multiple-daily dosing in terms of efficacy and/or toxicity, in patients with cystic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.
Both reviewers independently extracted data and assessed trial quality. Authors of one study were contacted to obtain missing information.
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.
囊性纤维化患者长期被铜绿假单胞菌定植，在治疗肺部病情加重时，常常需要反复静脉注射氨基糖苷类抗生素。氨基糖苷类药物的特性表明，可以减少给药频率并提高给药浓度。
评估静脉注射氨基糖苷类抗生素每日一次给药与每日多次给药治疗囊性纤维化肺部病情加重的有效性和安全性。
我们检索了Cochrane囊性纤维化和遗传疾病小组编辑基地保存的囊性纤维化专科试验注册库，其中包括通过全面电子数据库检索、手工检索相关期刊以及手工检索会议论文摘要集确定的参考文献。最近一次检索日期为2000年2月。
所有随机对照试验，无论是否发表，只要是在囊性纤维化患者中比较了氨基糖苷类药物每日一次给药与每日多次给药的疗效和/或毒性。
两位综述作者独立提取数据并评估试验质量。联系了一项研究的作者以获取缺失信息。
本综述纳入了两项试验，共70名患者的结果。两项试验均比较了每日一次给药与每日三次给药，报告了一秒用力呼气量（FEV1）、用力肺活量（FVC）、营养状况和副作用的数据。治疗组之间在疗效、耳毒性和肾毒性发生率方面没有显著差异。
尽管两组之间没有差异，但我们认为这些结果应谨慎看待，因为涉及的患者数量较少，缺乏检测两组之间差异的能力。这项系统综述强调了需要进行一项设计良好、样本量充足的多中心随机对照试验，以评估静脉注射氨基糖苷类药物每日一次给药与每日多次给药治疗囊性纤维化肺部病情加重的疗效。
