Reynolds A V, Hamilton-Miller J M, Brumfitt W
Br Med J. 1974 Sep 28;3(5934):778-80. doi: 10.1136/bmj.3.5934.778.
Tobramycin and amikacin are new aminoglycoside antibiotics which resemble gentamicin and kanamycin respectively in pharmacokinetic, toxicological, and some microbiological respects. Minimum inhibitory concentrations for these four antibiotics have been determined against 393 bacterial strains (13 species from eight genera) isolated from clinical materialKanamycin was the least active, 89% of the Pseudomonas aeruginosa strains being resistant. Resistance was also found in 21% of the Klebsiella aerogenes, 16% of the indoleproducing Proteus species, 4% of the E. coli and 3% of the Enterobacter spp. tested. Providenca stuartii strains were often resistant to gentamicin and tobramycin.Apart from these exceptions, however, all the organisms tested were sensitive to all four compounds, gentamicin and tobramycin usually showing the highest intrinsic activity.Amikacin was the most active compound against a selection of strains chosen because of their resistance to one or more of the aminoglycosides. Thus, amikacin represents a significant advance over kanamycin and seems to be superior to gentamicin in terms of its in-vitro properties. This is especially the case in those unusual circumstances when gentamicin-resistant strains are a problem. We suggest that amikacin warrants further investigation since it may prove to be a valuable alternative to gentamicin in the treatment of life-threatening infections.
妥布霉素和阿米卡星是新型氨基糖苷类抗生素，在药代动力学、毒理学以及一些微生物学方面分别与庆大霉素和卡那霉素相似。已测定了这四种抗生素对从临床材料中分离出的393株细菌（来自8个属的13个种）的最低抑菌浓度。卡那霉素活性最低，89%的铜绿假单胞菌菌株耐药。产气克雷伯菌中有21%、产吲哚变形杆菌中有16%、大肠埃希菌中有4%以及所检测的阴沟肠杆菌中有3%也发现有耐药性。斯氏普罗威登斯菌菌株通常对庆大霉素和妥布霉素耐药。然而，除了这些例外情况，所有检测的菌株对这四种化合物均敏感，庆大霉素和妥布霉素通常显示出最高的固有活性。阿米卡星是对因对一种或多种氨基糖苷类耐药而挑选出的一系列菌株活性最强的化合物。因此，就其体外特性而言，阿米卡星相对于卡那霉素有显著进展，且似乎优于庆大霉素。在庆大霉素耐药菌株成为问题的那些特殊情况下尤其如此。我们建议对阿米卡星进行进一步研究，因为在治疗危及生命的感染时，它可能被证明是庆大霉素的一种有价值的替代药物。
