Once versus three-times daily regimens of tobramycin treatment for pulmonary exacerbations of cystic fibrosis—the TOPIC study: a randomised controlled trial

Tobramycin once- vs thrice-daily for elective intravenous antipseudomonal therapy in pediatric cystic fibrosis patients

“…CF was one of the examined subgroups, and the reviewers observed no statistically significant differences between once-and thrice-daily administration of tobramycin with respect to efficacy and safety of the drug. A recent randomized controlled trial in 244 CF patients demonstrated equal efficacy of a single-dose tobramycin treatment (instead of three doses daily) with even less nephrotoxicity [16]. Nevertheless.…”

“…The clinical trials on once-vs thrice-daily dosing of aminoglycosides for CF patients have all been performed in patients with acute respiratory exacerbations or infections [12][13][14][15][16]. To date, there is no published data available for patients who received elective antipseudomonal treatment during clinically stable phases.…”

In vivo efficacy of humanised intermittent versus continuous ceftazidime in combination with tobramycin in an experimental model of pseudomonal pneumonia

“…once daily; the objective was to obtain a concentration of 30 mg/L at the end of the infusion [7,21].…”

Twice vs three-times daily antibiotics in the treatment of pulmonary exacerbations of cystic fibrosis

“…These features led investigators to believe that once daily dosing of aminoglycosides might be more effective with less frequent side effects such as nephrotoxicity and ototoxicity [5]. However, a number of studies have failed to show a significant improvement in treatment outcomes or side effect frequency [6][7][8]. The largest study in a CF population, the TOPIC study, reported equal efficacy between once and three-times daily tobramycin given with ceftazidime, with a trend to less nephrotoxicity in children [7].…”

“…However, a number of studies have failed to show a significant improvement in treatment outcomes or side effect frequency [6][7][8]. The largest study in a CF population, the TOPIC study, reported equal efficacy between once and three-times daily tobramycin given with ceftazidime, with a trend to less nephrotoxicity in children [7]. Over the recent years once daily dosing of aminoglycosides has been adopted in most CF centres based on its potential to reduce toxicity and supposed convenience over three-times daily dosing.…”