Höffler D, Koeppe P, Demers H G
J Infect Dis. 1976 Nov;134 SUPPL:S369-73. doi: 10.1093/infdis/135.supplement_2.s369.
Amikacin (250 mg four times daily for 10 days) was administered intramuscularly to 22 patients with long-standing, severe infections of the urinary tract, in each case superimposed on chronic uropathy or nephropathy. Therapy with amikacin was completely successful in 14 patients (sterile 14-day follow-up urine specimens obtained by suprapubic needle aspiration of the bladder) and partially successful in three (sterile three-day but positive 14-day follow-up urine specimens). Five patients were judged to be treatment failures. Quantitative assessment of pyuria revealed a significant drop in the rate of excretion of white cells to near normal levels not only in patients who were cured but also in others, a finding which suggests that the infectious process had been affected by amikacin in all cases. The course of the disease in individual patients suggested that amikacin therapy can be successful after a long series of failures from treatment of such conditions with other antibiotics. Additional pharmacokinetic studies indicated that the half-life of amikacin may be increased five- to 10-fold in patients with renal insufficiency. A tentative dosage schedule was prepared for patients with various degrees of impaired renal function on the basis of average half-life values.
对22例患有长期严重尿路感染的患者（均伴有慢性泌尿系统疾病或肾病）进行了阿米卡星治疗（每日4次，每次250毫克，共10天），采用肌肉注射给药。阿米卡星治疗在14例患者中完全成功（通过膀胱耻骨上穿刺抽吸获得无菌的14天随访尿液样本），在3例患者中部分成功（3天尿液无菌，但14天随访尿液样本呈阳性）。5例患者被判定为治疗失败。对脓尿的定量评估显示，不仅治愈的患者，其他患者的白细胞排泄率也显著下降至接近正常水平，这一发现表明在所有病例中感染过程均受到了阿米卡星的影响。个别患者的病程表明，在使用其他抗生素治疗此类疾病多次失败后，阿米卡星治疗仍可能成功。额外的药代动力学研究表明，肾功能不全患者中阿米卡星的半衰期可能会延长5至10倍。根据平均半衰期值，为不同程度肾功能受损的患者制定了初步的给药方案。
