Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
Cellular and Molecular Biology Research Center, Larestan University of Medical Sciences, Larestan, Iran.
Curr Mol Med. 2024;24(11):1358-1373. doi: 10.2174/1566524023666230801160452.
Aminoglycosides are among the first-choice antibiotics for routine clinical use. However, dose-limiting factors such as ototoxicity and nephrotoxicity are considered as serious complications of aminoglycosides.
In this systematic review, the main goal was to investigate the efficacy and incidence of nephrotoxicity and ototoxicity of once-daily dosing (ODD) and multiple daily dosing (MDD) regimens of aminoglycosides through available randomized controlled trials (RCTs).
We performed a literature-based research in relevant databases, including EMBASE, MEDLINE, and SCOPUS published between 1987 and 2023 using the keywords "aminoglycosides", "pharmacokinetics", "ODD", "MDD", "once daily", "multiple daily", "dosing regimen", "nephrotoxicity", "ototoxicity", "efficacy", "safety", and "toxicity". As so told, the results of this article were limited to papers available in English. Our initial search yielded 1124 results. After a review of the titles and abstracts of the articles, 803 articles were excluded from this study because they did not address the toxicity and effectiveness of ODD MDD of aminoglycosides. A total number of 20 studies on gentamicin, tobramycin, netilmicin, and amikacin met the inclusion criteria for the efficacy of aminoglycosides and their role in ototoxicity and nephrotoxicity were included in this review. Studies recruited different age classes, and the age of relevant cohorts varied from only a few days to more than 70 years.
The most common clinical condition in the included studies was cystic fibrosis.
In most studies, there were no significant differences between the two regimens regarding ototoxicity. In addition, the ODD regimens were safer than MDD concerning nephrotoxicity.
氨基糖苷类抗生素是常规临床应用的首选抗生素之一。然而，耳毒性和肾毒性等剂量限制因素被认为是氨基糖苷类抗生素的严重并发症。
在这项系统评价中，主要目的是通过现有的随机对照试验（RCT）调查氨基糖苷类药物每日一次给药（ODD）和多次每日给药（MDD）方案的疗效和肾毒性、耳毒性发生率。
我们在相关数据库中进行了基于文献的研究，包括 EMBASE、MEDLINE 和 SCOPUS，检索时间为 1987 年至 2023 年，使用的关键词为“氨基糖苷类”、“药代动力学”、“ODD”、“MDD”、“每日一次”、“多次每日”、“给药方案”、“肾毒性”、“耳毒性”、“疗效”、“安全性”和“毒性”。由于语言限制，本文的研究结果仅限于英文文献。我们的初步搜索产生了 1124 个结果。在对文章的标题和摘要进行审查后，803 篇文章被排除在本研究之外，因为它们没有涉及 ODD 和 MDD 方案的氨基糖苷类药物的毒性和有效性。共有 20 项关于庆大霉素、妥布霉素、奈替米星和阿米卡星的研究符合纳入氨基糖苷类药物疗效和耳毒性和肾毒性作用的标准，并纳入本综述。这些研究招募了不同年龄组的患者，相关队列的年龄从几天到 70 多岁不等。
纳入研究中最常见的临床情况是囊性纤维化。
在大多数研究中，两种方案在耳毒性方面没有显著差异。此外，与 MDD 方案相比，ODD 方案在肾毒性方面更安全。
