Evaluation of Single-dose Aminoglycoside Therapy for Treatment of Urinary Tract Infections
by Grace Mortrude, PharmD, BCIDP, Alexis Bozich, PharmD, Courtney Pagels, PharmD, BCIDP
Abstract
Purpose:
Patients with cystitis due to multidrug-resistant organisms often have few outpatient treatment options. The Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections recommends single-dose aminoglycoside treatment as an alternative for cystitis caused by multidrug-resistant organisms, however robust evidence is lacking. This treatment strategy is used at a Veterans Affairs Medical Center (VAMC), and thus, the purpose of this project is to describe our experience.
Methods:
This retrospective descriptive cohort included patients at this VAMC who were treated with a single-dose of aminoglycoside for urinary tract infection between April 2019 and April 2024. The primary outcome assessed was successful treatment, defined as no urinary tract infection recurrence within 90 days of single-dose aminoglycoside treatment. Secondary outcomes included microbial cure and adverse effects.
Results:
Nine patients met the inclusion criteria over the studied period. Five patients received gentamicin, 4 received amikacin, and 0 patients received tobramycin. All patients were treated for uncomplicated urinary tract infection, except one, who was treated for pyelonephritis. Treatment was successful in 6 of the 9 patients. Microbial cure occurred in 1 of the 4 patients in whom it could be assessed. No adverse effects were reported in the electronic health record.
Conclusions:
Treatment of cystitis with single-dose aminoglycoside therapy is a reasonable treatment consideration for those without other outpatient treatment options. More robust clinical data is needed to further assess the efficacy and safety of this treatment.
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2026 March/April Table of Contents
Abstract
Purpose:
Patients with cystitis due to multidrug-resistant organisms often have few outpatient treatment options. The Infectious Diseases Society of America 2024 Guidance on the Treatment of Antimicrobial Resistant Gram-Negative Infections recommends single-dose aminoglycoside treatment as an alternative for cystitis caused by multidrug-resistant organisms, however robust evidence is lacking. This treatment strategy is used at a Veterans Affairs Medical Center (VAMC), and thus, the purpose of this project is to describe our experience.
Methods:
This retrospective descriptive cohort included patients at this VAMC who were treated with a single-dose of aminoglycoside for urinary tract infection between April 2019 and April 2024. The primary outcome assessed was successful treatment, defined as no urinary tract infection recurrence within 90 days of single-dose aminoglycoside treatment. Secondary outcomes included microbial cure and adverse effects.
Results:
Nine patients met the inclusion criteria over the studied period. Five patients received gentamicin, 4 received amikacin, and 0 patients received tobramycin. All patients were treated for uncomplicated urinary tract infection, except one, who was treated for pyelonephritis. Treatment was successful in 6 of the 9 patients. Microbial cure occurred in 1 of the 4 patients in whom it could be assessed. No adverse effects were reported in the electronic health record.
Conclusions:
Treatment of cystitis with single-dose aminoglycoside therapy is a reasonable treatment consideration for those without other outpatient treatment options. More robust clinical data is needed to further assess the efficacy and safety of this treatment.
Download PDF
2026 March/April Table of Contents