Comparative Trial of Single‐Dose Versus Twice‐Daily Sisomicin in Bacteriuric Patients

Abstract

Sisomicin was administered as a single daily intramuscular injection (160 mg) or as two daily injections (80 mg) to 50 patients with bacteriuria superimposed on chronic urologic diseases in a randomized controlled fashion. The administration of two daily doses was significantly more effective (P less than 0.01) in achieving cure than the injection of a single daily dose. The renal function, as expressed by creatinine clearance, became impaired significantly more often (P less than 0.05) in the patients receiving the single daily dose of sisomicin.

A Meta-Analysis of the Relative Efficacy and Toxicity of Single Daily Dosing Versus Multiple Daily Dosing of Aminoglycosides

“…All patients in three studies [35,38,41] and the majority of patients in one study [40] underwent primary surgical intervention for the treatment of intra-abdominal infections. All patients in two studies [33,44] and the majority of patients in two other reports [46,49] had urinary tract infections. All patients in two studies [50,53] and more than half of all patients in another [37] were neutropenic.…”

Single or multiple daily doses of aminoglycosides: a meta- analysis

“…We identified 25 trials1 4 5 7 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 and used 21 of them, with a total of 3091 patients, in the meta-analysis (table 1). We excluded four studies, three because the total daily dose of aminoglycosides was different in the two treatment arms32 33 34 and the fourth because aminoglycosides were used for prophylaxis for colorectal surgery 31.…”

“…Finally, the specific drug used bore no significant relation to the relative risk of failure in the two treatment arms of the study. An exception was the one study of sisomicin, which is not commercially available 5. Only this trial showed a significantly better efficacy with multiple daily doses (fig 1).…”

“…Although a few studies showed one or the other regimen to be of superior merit,1 5 most found no significant difference in efficacy or toxicity between the two regimens. Individual trials, however, have been of relatively small size, and their power to detect a significant difference in outcome was low.…”

Aminoglycosides: single or multiple daily dosing?

“…In total 16 publications were included [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The publications were searched for electronically through the Index Medicus and through lists of references.…”