Feld R, Valdivieso M, Bodey G P, Rodriguez V
Am J Med Sci. 1977 Sep-Oct;274(2):179-88. doi: 10.1097/00000441-197709000-00010.
One hundred and thirty-nine febrile episodes in 120 patients were treated with sisomicin after a combination of carbenicillin and a cephalosporin antibiotic had failed. These patients were randomized to receive sisomicin either by continuous or by intermittent infusion. The response rate for patients treated with sisomicin was 61 percent by continuous infusion and 46 percent by intermittent infusion, which was not statistically significant. Pneumonia, septicemia, and soft tissue infections were the most frequent infections. Most (96 percent) of the identified pathogens were gram-negative bacilli with the most frequent being Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa. The response rate was higher in those patients whose neutrophil count increased or remained the same while on therapy. The worst response was obtained if there was a decrease in the neutrophil count during therapy. The major toxicity of sisomicin was found to be azotemia and occurred in 17 percent of episodes treated by continuous infusion and in 21 percent treated by intermittent infusion. Hearing loss in the high frequency range occurred in five patients. Sisomicin is effective in the treatment of gram negative infections in neutropenic cancer patients.
120名患者出现139次发热发作，在羧苄青霉素和一种头孢菌素抗生素联合使用失败后，使用西索米星进行治疗。这些患者被随机分为接受持续输注或间歇输注西索米星。接受持续输注西索米星治疗的患者有效率为61%，间歇输注的为46%，差异无统计学意义。肺炎、败血症和软组织感染是最常见的感染。鉴定出的病原体大多数（96%）为革兰氏阴性杆菌，最常见的是肺炎克雷伯菌、大肠埃希菌和铜绿假单胞菌。治疗期间中性粒细胞计数增加或保持不变的患者有效率更高。如果治疗期间中性粒细胞计数下降，则有效率最差。西索米星的主要毒性为氮质血症，持续输注治疗的发作中有17%出现，间歇输注治疗的有21%出现。5名患者出现高频听力丧失。西索米星对治疗中性粒细胞减少的癌症患者的革兰氏阴性感染有效。
