A Cochrane review included 4 studies with a total of 328 subjects assessing the effectiveness and safety of once-daily versus multiple-daily dosing of intravenous aminoglycoside antibiotics for the management of pulmonary exacerbations in cystic fibrosis. All studies compared once-daily dosing with thrice-daily dosing. There was no significant difference between treatment groups in forced expiratory volume at one second (MD 0.33, 95% CI -2.81 to 3.48); forced vital capacity (MD 0.29, 95% CI -6.58 to 7.16); % weight for height (MD -0.82, 95% CI -3.77 to 2.13); body mass index (MD 0.00, 95% CI -0.42 to 0.42); or in the incidence of ototoxicity (RR 0.56, 95% CI 0.04 to 7.96). The percentage change in creatinine significantly favoured once-daily treatment in children (MD -8.20, 95% CI -15.32 to -1.08), but showed no difference in adults (MD 3.25, 95% CI -1.82 to 8.33); in adults the effect was in favour of three-times daily treatment, but was not significant.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).