Introduction::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.
Objective::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).
Methods::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 versus 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.
Results::The most common clinical
condition in the included studies was cystic fibrosis.
Conclusion::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.