| Comparison of two dosing regimens of aminoglycosides for the development of nephrotoxicity: once versus multiple daily dosing |
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Byung Don Choi, Baek Nam Kim |
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고려대학교 의과대학 내과학교실 |
| 원저:Aminoglycoside계 항균제 1일 1회 투여법과 1일 다회 투여법에서 신독성의 발생 비교 |
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최병돈, Baek Nam Kim |
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| Abstract |
Background : Aminoglycosides are useful for the treatment of aerobic gram-negative infections,
and this is despite the narrow therapeutic index and the potential nephrotoxicity and ototoxicity. Once
daily dosing of aminoglycosides has recently been suggested as an alternative method to multiple
daily dosing. We compared the two dosing regimens of aminoglycosides for the development of
nephrotoxicity.
Methods
: This study was conducted as part of an ongoing quality improvement program. For
the administration of aminoglycosides in adult patients with suspected or documented gram-negative
infection, multiple daily dosing was used until April 2005 and thereafter once daily dosing was
recommended.
Results
: A total of 85 patients who received aminoglycoside for more than 3 days from March
to August 2005 were available for analysis (40 in the once daily dosing group and 45 in the multiple
daily dosing group). The mean duration of administration was 7.7 (range: 3-19) days in the once
daily dosing group and 8.0 (range: 3-31) days in the multiple daily dosing group (p=0.83).
Aminoglycoside-associated nephrotoxicity was observed in a patient in the once daily dosing group
(2.5% vs 0%, respectively, p=0.48).
Conclusions
: No significant difference in the development of nephrotoxicity was found between
the two dosing regimens for aminoglycosides, but this finding had low statistical power. This may
be due to underdosing of aminoglycosides in the multiple daily dosing group.(Korean J Med
71:543-550, 2006)
Key Words : Aminoglycosides, Drug administration schedule, Toxicity, Acute renal failure |
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