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Efficacy and safety of aminoglycoside monotherapy: systematic review and meta-analysis of randomised controlled trials

Abstract number: 1732_88

Vidal L., Gafter-Gvili A., Borok S., Fraser A., Leibovici L., Paul M.

Objectives: The use of aminoglycosides has decreased due to doubts regarding lack of efficacy and adverse effects. Yet, the prevalence of microbial resistance to aminoglycosides has remained low. This study sought to compare the efficacy and adverse effects of aminoglycosides as a single antibiotic to other antibiotics for the treatment of patients with infection.

Methods: We searched for randomised trials comparing the efficacy of aminoglycoside antibiotic treatment to non-aminoglycoside antibiotic in patients with infection in the Cochrane Library, MEDLINE, EMBASE, LILACS, databases of ongoing trials and conference proceedings. Two reviewers assessed trial eligibility, quality and extract data. Pooled relative risks (RR) with 95% confidence intervals (CI) were calculated for dichotomous data.

Results: The search yielded 37 trials. 27 trials assessed patients with urinary tract infection, 5 trials assessed patients with other source of infection and 5 did not define the source of infection. Aminoglycosides were equally effective as comparator in analysis of mortality (RR 1.26, 95% CI: 0.68, 2.31, n = 458) and treatment failure (RR 1.10, 95% CI: 0.96, 1.27, n = 1908), but were associated with significant more bacteriological failure (RR 1.39, 95% CI: 1.14, 1.68, n = 1242). Subgroup analyses according to quality of trial, type of antibiotics, source of infection and, rate of clinical sepsis did not alter the outcomes. Less adverse effects in total but more nephrotoxic effects were observed in patients treated with aminoglycosides.

Conclusions: The present data supports the use of aminoglycosides as treatment for urinary tract infection but not as single treatment for patients with infections other than the urinary tract.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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