Hahn D M, Schimpff S C, Young V M, Fortner C L, Standiford H C, Wiernik P H
Antimicrob Agents Chemother. 1977 Nov;12(5):618-24. doi: 10.1128/AAC.12.5.618.
Amikacin (15 mg/kg per day) was used in combination with cephalothin (7 g/m(2) per day) as an empiric regimen for de novo febrile (>101 degrees F [38.3 degrees C]) episodes in 93 granulocytopenic (<1,000/mm(3)) cancer patients. Both drugs were given intravenously in four equal doses every 6 h. The response rate for all documented infections was 83%, including 11 of 17 (65%) bacteremias. Escherichia coli (14 cases) was the most common pathogen, whereas Pseudomonas aeruginosa (2 cases) caused fewer infections. Mean amikacin serum levels were 8.7 mug/ml at 1 h and 2.2 mug/ml at 5 h. Failure of bone marrow recovery in association with a bacteremia was a bad prognostic sign (only two of eight improving). Ototoxicity occurred in two (2%) patients, whereas presumed antibiotic-induced nephrotoxicity developed in six (7%) patients. Surveillance cultures (nose, gums axilla, and rectum) of all hospitalized patients revealed no significant change in the incidence of amikacin resistance. The combination of amikacin and cephalothin in this dose and schedule was safe and efficacious in these granulocytopenic patients.
在93例粒细胞减少（<1000/mm³）的癌症患者中，使用阿米卡星（每天15mg/kg）联合头孢噻吩（每天7g/m²）作为新发发热（>101°F [38.3°C]）发作的经验性治疗方案。两种药物均每6小时静脉注射4等份剂量。所有记录在案的感染的有效率为83%，包括17例菌血症中的11例（65%）。大肠杆菌（14例）是最常见的病原体，而铜绿假单胞菌（2例）引起的感染较少。阿米卡星血清平均水平在1小时时为8.7μg/ml，在5小时时为2.2μg/ml。菌血症伴骨髓恢复失败是不良预后征象（8例好转患者中仅2例）。2例（2%）患者出现耳毒性，6例（7%）患者出现疑似抗生素诱导的肾毒性。对所有住院患者进行的监测培养（鼻、牙龈、腋窝和直肠）显示，阿米卡星耐药发生率无显著变化。在这些粒细胞减少的患者中，此剂量和给药方案的阿米卡星与头孢噻吩联合用药安全且有效。
