Evaluation of once-daily dosing and target concentrations in therapeutic drug monitoring for arbekacin: A meta-analysis

Abstract Introduction Arbekacin is the first aminoglycoside antibacterial agent approved for treating methicillin-resistant Staphylococcus aureus infection in Japan. Although therapeutic drug monitoring (TDM) is recommended during arbekacin treatment, little evidence for the target exposure and once-daily dosing has been reported. This study aimed to clarify the target peak/trough concentrations and the effectiveness of once-daily dosing of arbekacin against nephrotoxicity or treatment failure via meta-analysis. Methods A literature search was performed using MEDLINE, Cochrane Library, and Ichushi-Web. Results Nine observational cohort studies met the inclusion criteria. A peak arbekacin concentration of ≥15–16 μg/mL did not exhibit a statistically significant lower risk of treatment failure (risk ratio [RR] = 0.61, 95% confidence interval [CI] = 0.30–1.24). A trough arbekacin concentration of Conclusions Once-daily dosing can improve the therapeutic efficacy of arbekacin, and a trough arbekacin concentration of