Adelman R D, Wirth F, Rubio T
Department of Pediatrics, University of California, Davis 95817.
J Pediatr. 1987 Dec;111(6 Pt 1):888-93. doi: 10.1016/s0022-3476(87)80212-3.
The nephrotoxicity of the aminoglycoside gentamicin was evaluated in an open, controlled study of newborn infants randomly allocated to receive either combination drug therapy with gentamicin and ampicillin or single drug therapy with mezlocillin for treatment of presumed neonatal sepsis. There were no significant differences in initial clinical characteristics between the groups. Neonates receiving gentamicin, in contrast to those receiving mezlocillin, had significant nephrotoxicity manifested by a smaller postnatal fall in mean serum creatinine concentration (-9%, P NS vs -21%, P less than 0.005, respectively) and a diminished postnatal rise in mean creatinine clearance (+ 21%, P NS vs + 51%, P less than 0.01, respectively). In neonates with a fall in creatinine clearance, the mean decline was significantly greater in those receiving gentamicin (44% vs 20%, P less than 0.01). There was no relationship between the incidence of gentamicin nephrotoxicity and either peak or trough gentamicin levels. For treatment of presumed neonatal sepsis, gentamicin proved more nephrotoxic than mezlocillin.
在一项开放性对照研究中，对随机分配接受庆大霉素与氨苄西林联合药物治疗或美洛西林单一药物治疗以治疗疑似新生儿败血症的新生儿进行了氨基糖苷类药物庆大霉素肾毒性的评估。两组的初始临床特征无显著差异。与接受美洛西林的新生儿相比，接受庆大霉素的新生儿出现了显著的肾毒性，表现为出生后平均血清肌酐浓度下降幅度较小（分别为-9%，P无统计学意义 vs -21%，P<0.005）以及出生后平均肌酐清除率升高幅度减小（分别为+21%，P无统计学意义 vs +51%，P<0.01）。在肌酐清除率下降的新生儿中，接受庆大霉素的新生儿平均下降幅度显著更大（44% vs 20%，P<0.01）。庆大霉素肾毒性的发生率与庆大霉素的峰浓度或谷浓度均无关联。对于疑似新生儿败血症的治疗，庆大霉素被证明比美洛西林具有更强的肾毒性。
