Marks S, Marks M I, Dupont C, Hammerberg S
Can Med Assoc J. 1978 Mar 18;118(6):659-62.
Emergence of gram-negative bacteria resistnant to a number of antibiotics in intensive care nurseries for neonates emphasizes the need for alternatives in antibiotic combinations. One commonly used combination, gentamicin-ampicillin, and two newer combinations, tobramycin-cephalothin and amikacinampicillin, were evaluated prospectively in 60 newborns in such a nursery. Subjects were randomly assigned to one of the above therapy groups. Dosages in mg/kg.d were 100 for ampicillin and cephalothin, 6 for gentamicin and tobramycin and 15 for amikacin. Aminoglycoside serum concentrations, clinical tolerance and toxicity were monitored. Aminoglycoside concentrations after intravenous administration of the drugs were within the expected range (gentamicin and tobramycin 4 to 6 microgram/mL and amikacin 15 to 20 microgram/mL). There was no hematologic, renal or hepatic toxicity attributable to antibiotic therapy and the combinations were tolerated equally; no bilirubin displacement was detected in vitro or in vivo.
在新生儿重症监护病房中，对多种抗生素耐药的革兰氏阴性菌的出现凸显了抗生素联合使用替代方案的必要性。在这样一个病房中，对60名新生儿前瞻性地评估了一种常用联合用药（庆大霉素 - 氨苄西林）以及两种新的联合用药（妥布霉素 - 头孢噻吩和阿米卡星 - 氨苄西林）。受试者被随机分配到上述治疗组之一。以mg/kg.d计的剂量分别为：氨苄西林和头孢噻吩100，庆大霉素和妥布霉素6，阿米卡星15。监测氨基糖苷类药物的血清浓度、临床耐受性和毒性。静脉给药后氨基糖苷类药物的浓度在预期范围内（庆大霉素和妥布霉素为4至6微克/毫升，阿米卡星为15至20微克/毫升）。抗生素治疗未引起血液学、肾脏或肝脏毒性，且各联合用药的耐受性相同；在体外或体内均未检测到胆红素置换现象。
