Herbrecht R, Blaise D, Espinouse D, Leblond V, Sadoun A, Sauvage C, Cordonnier C, Minozzi C
Service d'Onco-Hématologie, Hôpital de Hautepierre, France.
J Chemother. 1995 Jun;7 Suppl 2:103-10.
Isepamicin is a new aminoglycoside with in-vitro activity superior to amikacin. It is a poor substrate for the 6'-aminoacetyltransferase-I enzyme which inactivates amikacin and therefore organisms possessing this enzyme are not resistant to isepamicin. The aim of this study was to compare the efficacy and safety of co-administration of isepamicin once daily plus ceftriaxone to amikacin twice daily plus ceftriaxone to amikacin twice daily plus ceftriaxone in febrile neutropenic cancer patients. Febrile episodes in 235 patients (156 in isepamicin group and 79 in amikacin group) were treated in this study. They occurred in 218 different patients. Fifteen patients were enrolled twice and one three times. Response rates to the two treatment regimens for microbiologically documented episodes, clinically documented episodes and further unexplained fever were similar. Tolerance of the treatment regimens, as measured by serum creatinine levels, hypoaccousia and cutaneous allergy was also similar in both treatment groups. In conclusion, isepamicin given once daily when combined with ceftriaxone in the treatment of febrile episodes in neutropenic cancer patients was as effective and no more toxic than amikacin.
异帕米星是一种新的氨基糖苷类抗生素，其体外活性优于阿米卡星。它是6'-氨基乙酰转移酶-I的不良底物，该酶可使阿米卡星失活，因此，具有这种酶的微生物对异帕米星不耐药。本研究的目的是比较在发热性中性粒细胞减少的癌症患者中，异帕米星每日一次联合头孢曲松与阿米卡星每日两次联合头孢曲松的疗效和安全性。本研究对235例患者（异帕米星组156例，阿米卡星组79例）的发热发作进行了治疗。这些发作发生在218名不同的患者身上。15名患者被纳入两次，1名患者被纳入三次。对于微生物学确诊的发作、临床确诊的发作和进一步原因不明的发热，两种治疗方案的有效率相似。通过血清肌酐水平、听力减退和皮肤过敏来衡量，两个治疗组对治疗方案的耐受性也相似。总之，在治疗中性粒细胞减少的癌症患者的发热发作时，异帕米星每日一次联合头孢曲松与阿米卡星疗效相当，且毒性不更大。
