Matzke G R, Lucarotti R L, Shapiro H S
Am J Nephrol. 1983 Jan-Feb;3(1):11-7. doi: 10.1159/000166680.
317 patients with suspected or documented infections other than cystitis were randomly assigned to receive gentamicin or tobramycin dosed according to the Sawchuk/Zaske method or a modification of the McHenry method. 196 patients completed 6 days of therapy, had serial determinations of serum creatinine and were evaluated for nephrotoxicity. Within each dosing method group those patients receiving gentamicin and tobramycin had a similar mean age, initial serum creatinine level, total dose, duration of therapy and trough serum aminoglycoside concentration. Nephrotoxicity developed in 5 of 49 (10.2%) given gentamicin via the McHenry method compared to 9 of 49 (18.4%) given tobramycin. Similarily, 4 of 50 (8.0%) given gentamicin via the Sawchuk/Zaske method developed nephrotoxicity compared to 8 of 48 (16.7%) given tobramycin. Within the Sawchuk/Zaske and the modified McHenry dosing method groups, no significant difference was noted in the incidence of nephrotoxicity associated with gentamicin and tobramycin. 34% of patients with elevated trough serum aminoglycoside concentrations developed nephrotoxicity compared to 3.7% of those with nonelevated troughs (p less than 0.0005).
317例疑似或确诊为非膀胱炎感染的患者被随机分配，分别接受根据索丘克/扎斯克方法或麦克亨利方法的改良方法给药的庆大霉素或妥布霉素治疗。196例患者完成了6天的治疗，进行了血清肌酐的系列测定，并对肾毒性进行了评估。在每种给药方法组中，接受庆大霉素和妥布霉素的患者在平均年龄、初始血清肌酐水平、总剂量、治疗持续时间和血清氨基糖苷类药物谷浓度方面相似。通过麦克亨利方法给予庆大霉素的49例患者中有5例（10.2%）发生肾毒性，而给予妥布霉素的49例患者中有9例（18.4%）发生肾毒性。同样，通过索丘克/扎斯克方法给予庆大霉素的50例患者中有4例（8.0%）发生肾毒性，而给予妥布霉素的48例患者中有8例（16.7%）发生肾毒性。在索丘克/扎斯克和改良麦克亨利给药方法组中，与庆大霉素和妥布霉素相关的肾毒性发生率没有显著差异。血清氨基糖苷类药物谷浓度升高的患者中有34%发生肾毒性，而谷浓度未升高的患者中这一比例为3.7%（p<0.0005）。
