Wade J C, Smith C R, Petty B G, Lipsky J J, Conrad G, Ellner J, Lietman P S
Lancet. 1978 Sep 16;2(8090):604-6. doi: 10.1016/s0140-6736(78)92825-8.
In a prospective, randomised, double-blind trial to determine if cephalothin plus an aminoglycoside is more nephrotoxic than methicillin plus an aminoglycoside, patients were assigned to one of four treatment groups: cephalothin and gentamicin (C.G.), cephalothin and tobramycin (C.T.), methicillin and gentamicin (M.G.), or methicillin and tobramycin (M.T.). The incidence of definite nephrotoxicity was: C.G., 7/23 (30.4%); C.T., 5/24 (20.8%); M.G., 2/20 (10%); and M.T., 1/23 (4.3%). There was no statistically significant difference in nephrotoxicity between the combined gentamicin groups (C.G. and M.G.) and the combined tobramycin groups (C.T. and M.T.). Definite nephrotoxicity developed in 12/47 (25.5%) of the combined cephalothin groups (C.G. and C.T.) and in only 3/43 (7%) of the combined methicilllin groups (M.G. and M.T.). The combination of cephalothin plus an aminoglycoside is therefore more nephrotoxic than the combination of methicillin plus an aminoglycoside.
在一项前瞻性随机双盲试验中，为确定头孢噻吩加一种氨基糖苷类药物是否比甲氧西林加一种氨基糖苷类药物更具肾毒性，患者被分配到四个治疗组之一：头孢噻吩和庆大霉素（C.G.）、头孢噻吩和妥布霉素（C.T.）、甲氧西林和庆大霉素（M.G.）或甲氧西林和妥布霉素（M.T.）。明确肾毒性的发生率为：C.G.组，7/23（30.4%）；C.T.组，5/24（20.8%）；M.G.组，2/20（10%）；M.T.组，1/23（4.3%）。联合使用庆大霉素的组（C.G.和M.G.）与联合使用妥布霉素的组（C.T.和M.T.）之间的肾毒性无统计学显著差异。在联合使用头孢噻吩的组（C.G.和C.T.）中，12/47（25.5%）出现明确肾毒性，而在联合使用甲氧西林的组（M.G.和M.T.）中仅3/43（7%）出现明确肾毒性。因此，头孢噻吩加一种氨基糖苷类药物的组合比甲氧西林加一种氨基糖苷类药物的组合更具肾毒性。
