Beaucaire G, Leroy O, Beuscart C, Karp P, Chidiac C, Caillaux M
Intensive Care and Infectious Diseases Unit, University of Lille, Centre Hospitalier Dron, Tourcoing, France.
J Antimicrob Chemother. 1991 May;27 Suppl C:91-103. doi: 10.1093/jac/27.suppl_c.91.
In a multicentre non-randomized open prospective study, 124 patients hospitalized in medical infectious disease or intensive care units, with severe community and hospital-acquired bacterial infections were treated with 15 mg/kg body weight amikacin in a once-daily dose given as a 30 min iv infusion, combined with other antibiotics. Infections were bacteriologically proven in 101 patients. The clinical responses showed 83.1% primary success and 83.9% definitive cure predominantly in intensive care patients with hospital-acquired infections and pneumonia. Bacteriological eradication was achieved in 67.3%. Bacteria associated with true failures and colonizations were predominantly Pseudomonas, Acinetobacter and Staphylococcus spp. The risk of nephrotoxicity may be decreased with such a regimen of amikacin, but no conclusions could be drawn with regard to ototoxicity. In summary, a once-daily dosing regimen of amikacin 15 mg/kg is practical and probably efficacious and safe in severely infected patients.
在一项多中心非随机开放前瞻性研究中，124例因严重社区获得性和医院获得性细菌感染而入住医学传染病科或重症监护病房的患者，接受了15mg/kg体重的阿米卡星治疗，每日一次，静脉输注30分钟，同时联合使用其他抗生素。101例患者的感染得到细菌学证实。临床反应显示，主要在患有医院获得性感染和肺炎的重症监护患者中，初始成功率为83.1%，最终治愈率为83.9%。细菌清除率为67.3%。与真正治疗失败和定植相关的细菌主要是假单胞菌属、不动杆菌属和葡萄球菌属。采用这种阿米卡星治疗方案可能会降低肾毒性风险，但关于耳毒性无法得出结论。总之，对于严重感染患者，每日一次15mg/kg的阿米卡星给药方案是可行的，可能有效且安全。
