Cunha B A
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501.
Pharmacotherapy. 1988;8(6):334-50. doi: 10.1002/j.1875-9114.1988.tb04092.x.
Aminoglycosides remain the cornerstone of antibiotic therapy for nosocomial, gram-negative bacillary infections despite the recent introduction of broad-spectrum beta-lactam antibiotics and quinolones with antipseudomonal activity. Initially, aminoglycosides were used as antiaerobic gram-negative antimicrobial therapy. Currently, they have a key role in many types of infections, such as gram-negative urosepsis and in febrile granulocytopenic patients, because of their established antipseudomonal activity. Empiric treatment of febrile episodes in granulocytopenic cancer patients with an aminoglycoside, in combination with an anti-pseudomonal beta-lactam, accounts for much of the aminoglycoside use. Amikacin is emerging as one of the most effective aminoglycosides on the basis of resistance rates, pharmacokinetic factors likely to affect clinical efficacy, safety, and overall cost of therapy.
尽管最近引入了具有抗假单胞菌活性的广谱β-内酰胺抗生素和喹诺酮类药物，但氨基糖苷类药物仍然是治疗医院获得性革兰氏阴性杆菌感染的抗生素疗法的基石。最初，氨基糖苷类药物被用作抗需氧革兰氏阴性菌的抗菌疗法。目前，由于其已确立的抗假单胞菌活性，它们在许多类型的感染中发挥着关键作用，例如革兰氏阴性菌败血症和发热性粒细胞减少症患者。在粒细胞减少的癌症患者中，使用氨基糖苷类药物联合抗假单胞菌β-内酰胺类药物对发热发作进行经验性治疗，占氨基糖苷类药物使用量的很大一部分。基于耐药率、可能影响临床疗效的药代动力学因素、安全性和总体治疗成本，阿米卡星正成为最有效的氨基糖苷类药物之一。
