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The major limitation to clinical use of aminoglycosides is concern about their nephrotoxic and ototoxic effects. This randomized, double-blind, U.S. trial compared the nephrotoxicity and ototoxicity associated with once-daily or twice-daily administration of aminoglycosides in 123 patients with suspected or proven gram-negative bacterial infections. Of the total, 83 patients were evaluated who received therapy for at least 72 hours. Plasma aminoglycoside concentrations, prospective aminoglycoside dosage adjustment, and serial audiologic and renal status evaluations were performed. Patients also received concomitant antibiotics as necessary. Efficacy was not evaluated in this trial.
Nephrotoxicity occurred in six of 39 (15.4%) patients receiv…