Tange R A, Dreschler W A, Prins J M, Büller H R, Kuijper E J, Speelman P
Department of Otorhinolaryngology, Internal Medicine, Unit for Infectious Diseases and Tropical Medicine and Medical, Academic Medical Centre, Amsterdam, The Netherlands.
Clin Otolaryngol Allied Sci. 1995 Apr;20(2):118-23. doi: 10.1111/j.1365-2273.1995.tb00026.x.
In the treatment of serious infection by aminoglycoside antibiotics multiple daily treatment with netilmicin is considered to be the least toxic. Studies comparing netilmicin with gentamicin using the less toxic once-daily schedule are lacking. A randomized prospective study was designed to evaluate the efficacy and toxicity of once-daily netilmicin with gentamicin treatment in patients with serious infections. Consecutive patients with serious infections were randomized between gentamicin 4 mg/kg q24h iv or netilmicin 5.5 mg/kg q24h iv. Exclusion criteria were neutropenia or severe renal failure. A good clinical response was observed in 50 of the 54 evaluable patients (92.6%) treated with gentamicin and in 48/52 (92.3%) netilmicin treated patients. Nephrotoxicity developed in 5/72 (6.9%) gentamicin patients and in 10/69 (14.5%) treated with netilmicin. Audiometry was performed with high-frequency audiometry when possible; no significant differences were found between the two aminoglycosides. We conclude that with once-daily treatment no benefit of netilmicin over gentamicin regarding nephro- or ototoxicity could be demonstrated.
在氨基糖苷类抗生素治疗严重感染时，每日多次使用奈替米星被认为毒性最小。目前缺乏使用毒性较小的每日一次给药方案比较奈替米星和庆大霉素的研究。一项随机前瞻性研究旨在评估每日一次使用奈替米星与庆大霉素治疗严重感染患者的疗效和毒性。连续的严重感染患者被随机分为接受静脉注射庆大霉素4mg/kg每24小时一次或奈替米星5.5mg/kg每24小时一次。排除标准为中性粒细胞减少或严重肾衰竭。在54例可评估的接受庆大霉素治疗的患者中有50例（92.6%）观察到良好的临床反应，在52例接受奈替米星治疗的患者中有48例（92.3%）观察到良好的临床反应。5/72（6.9%）接受庆大霉素治疗的患者和10/69（14.5%）接受奈替米星治疗的患者出现肾毒性。尽可能进行高频听力测定；两种氨基糖苷类药物之间未发现显著差异。我们得出结论，每日一次给药时，未证明奈替米星在肾毒性或耳毒性方面优于庆大霉素。
