Serieys C, Bergogne-Bérézin E, Prokocimer P, Delcercq D
Pathol Biol (Paris). 1986 May;34(5):490-3.
O-demethyl-fortimicin-A-sulfate (ODMF) is a semisynthetic derivative of fortimicin-A with increased in vitro activity especially against Pseudomonas aeruginosa. This study was designed to determine the efficacy of ODMF in the treatment of UTI and to evaluate the in vitro susceptibility of bacteria isolated from the urine of patients to ODMF as compared to tobramycin (To), gentamicin (Ge) and amikacin (Ak). In 28 hospitalized patients with acute UTI, ODMF (free base) in a dose of 2 to 5 mg/kg was administered during 7 to 14 days. Every 2 days and at least 5 times during therapy, ODMF serum levels were determined (peak and trough levels) for dosage adjustment. Urine cultures were performed on day 0 and between days 2 and 4, and susceptibility of the organisms was determined. Patients were monitored for oto and nephrotoxicity. The treatment was successful in 53.5% of patients. 35.5% of patients relapsed due to severe underlying disease. ODMF was discontinued or given in reduced dosages in 10.7% of cases because of an increase in serum creatinine during therapy. Among the 37 significant strains recovered from urine, there were 54% E. coli, 10.8% Enterobacter sp., 10.8% Proteus sp., and 10.8% Pseudomonas sp. Resistance to ODMF was demonstrated in only 5.8% of strains, against 14.7% for Ge and 11.7% for To. Susceptibility of the strains was very similar for ODMF and Ak. On the whole, clinical and bacteriological results were satisfactory and did not differ from those usually obtained with aminoglycosides in the treatment of UTI due to Gram negative bacilli.
硫酸O - 去甲基福提霉素A（ODMF）是福提霉素A的半合成衍生物，其体外活性增强，尤其对铜绿假单胞菌。本研究旨在确定ODMF治疗尿路感染（UTI）的疗效，并评估从患者尿液中分离出的细菌与妥布霉素（To）、庆大霉素（Ge）和阿米卡星（Ak）相比对ODMF的体外敏感性。在28例急性UTI住院患者中，给予剂量为2至5mg/kg的ODMF（游离碱），疗程7至14天。治疗期间每2天至少测定5次ODMF血清水平（峰值和谷值水平）以调整剂量。在第0天以及第2至4天之间进行尿培养，并测定细菌的敏感性。对患者进行耳毒性和肾毒性监测。53.5%的患者治疗成功。35.5%的患者因严重基础疾病复发。10.7%的病例因治疗期间血清肌酐升高而停用ODMF或减少剂量。从尿液中分离出的37株重要菌株中，大肠杆菌占54%，肠杆菌属占10.8%，变形杆菌属占10.8%，假单胞菌属占10.8%。仅5.8%的菌株对ODMF耐药，而对Ge耐药率为14.7%，对To耐药率为11.7%。ODMF和Ak对菌株的敏感性非常相似。总体而言，临床和细菌学结果令人满意，与氨基糖苷类药物治疗革兰阴性杆菌所致UTI通常获得的结果无差异。
