Kumin G D
JAMA. 1980 Oct 17;244(16):1808-10.
Nearly 3.2 million people in this country receive aminoglycoside antibiotics annually. Gentamicin sulfate and tobramycin sulfate continue to demonstrate ototoxicity and nephrotoxicity in both animal and clinical studies. In this study, 62 patients with confirmed initial normal renal function and treated with 2 to 5 mg/kg/day of gentamicin sulfate or tobramycin sulfate for a minimum of seven days were followed up prospectively for the development of aminoglycoside-related renal failure, defined as at least a one-third reduction in renal function. In these 62 patients, no other causes for renal failure could be identified. Five of 33 (15%) of the tobramycin-treated patients and 16 of 29 (55.2%) of the gentamicin-treated patients had renal failure. Thus, gentamicin was associated with renal failure more than three times as often as was tobramycin.
该国每年有近320万人接受氨基糖苷类抗生素治疗。硫酸庆大霉素和硫酸妥布霉素在动物和临床研究中均持续表现出耳毒性和肾毒性。在本研究中，对62例初始肾功能确认正常、接受每日2至5mg/kg硫酸庆大霉素或硫酸妥布霉素治疗至少7天的患者进行了前瞻性随访，观察氨基糖苷类相关肾衰竭的发生情况，氨基糖苷类相关肾衰竭定义为肾功能至少降低三分之一。在这62例患者中，未发现其他肾衰竭原因。接受妥布霉素治疗的33例患者中有5例（15%）发生肾衰竭，接受庆大霉素治疗的29例患者中有16例（55.2%）发生肾衰竭。因此，庆大霉素导致肾衰竭的几率是妥布霉素的三倍多。
