Marget W, Reindke B, Versmold H
J Infect Dis. 1976 Nov;134 SUPPL:S412-9. doi: 10.1093/infdis/135.supplement_2.s412.
Trends in relative susceptibility of clinical isolates, mostly from newborns with nosocomial infections, to the aminoglycosides in use in a hospital for children are described and related to practical therapeutic aspects. Currently, amikacin is the most effective of the available antibiotics against many gram-negative bacterial species, and its administration appears to be as complicated as that of other aminoglycosides. With 5 mug/ml taken as the cut-off point for susceptibility in vitro, 90% of 211 clinical isolates (Pseudomonas aeruginosa, Escherichia coli, Klebsiella, Serratia, and other species) could be considered sensitive to amikacin; the respective figures for sensitivity to sisomicin, gentamicin, and tobramycin were 80.5%, 66%, and 70%. Cross-resistance of microorganisms to amikacin and gentamicin, sisomicin, or tobramycin has not been demonstrated. Treatment with amikacin was successful in 13 of 15 children (premature and normal newborns with primarily septicemia); death of two patients was attributable to the underlying disease. For neonatal infections we recommend 12 mg of amikacin/kg per day; determination of the minimal inhibitory concentration for the causative pathogen and monitoring of serum concentrations are desirable.
本文描述了一家儿童医院中临床分离菌株（大多来自患有医院感染的新生儿）对所用氨基糖苷类药物的相对敏感性趋势，并将其与实际治疗情况相关联。目前，阿米卡星是现有抗生素中对许多革兰氏阴性菌最有效的药物，其给药过程似乎与其他氨基糖苷类药物一样复杂。以5微克/毫升作为体外药敏试验的临界值，211株临床分离菌株（铜绿假单胞菌、大肠杆菌、克雷伯菌、沙雷菌及其他菌种）中有90%可被认为对阿米卡星敏感；对西索米星、庆大霉素和妥布霉素敏感的相应比例分别为80.5%、66%和70%。尚未证实微生物对阿米卡星与庆大霉素、西索米星或妥布霉素之间存在交叉耐药性。15例儿童（早产和足月新生儿，主要患有败血症）中，13例使用阿米卡星治疗成功；2例患者死亡归因于基础疾病。对于新生儿感染，我们建议每日剂量为12毫克阿米卡星/千克体重；最好测定致病病原体的最低抑菌浓度并监测血清浓度。
