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Zur klinischen Wirksamkeit, Nephrotoxizität und Ototoxizität des Amikacins

Clinical efficacy, nephrotoxicity and ototoxicity of amikacin

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Zusammenfassung

Die klinische Wirksamkeit und Verträglichkeit des Amikacins wurde bei 22 Patienten, die vorwiegend an chronischen Harntraktinfektionen erkrankt und bereits mehrfach mit anderen Antibiotika erfolglos vorbehandelt worden waren, untersucht. Amikacin wurde in einer Dosierung von 2 × 7,5 mg pro kg pro Tag durchschnittlich während 11,4 Tagen i.m. verabreicht. Diesem neuen Aminoglykosid-Antibiotikum wurde eine hohe Wirksamkeit bei der Behandlung chronischer Pyelonephritiden und Zystitiden sowie einer Sepsis mit gentamicinresistentenPseudomonas-Keimen bescheinigt. Die pharmakokinetischen Untersuchungen ließen nach zehntägiger Amikacinbehandlung keine Retention erkennen. Auch durch eine minutiöse nephro- und otologische Fahndung nach Nebenwirkungen waren keine dauerhaften nephrooder ototoxischen Schäden und auch keine Spätschäden nachzuweisen. Die Ergebnisse wurden mit den in der Literatur vorhandenen klinischen und experimentellen Daten sowie mit noch nicht veröffentlichten experimentellen Untersuchungsergebnissen verglichen.

Summary

The clinical efficacy and toleration of amikacin was investigated in 22 patients most of whom had chronic urinary tract infections that had already been treated unsuccessfully on several occasions with other antibiotics. Amikacin was administered i.m. in a dosage of 7.5 mg per kg twice daily for an average of 11.4 days. This new aminoglycoside antibiotic proved highly effective in the treatment of chronic pyelonephritis and cystitis, as well as in septicaemia caused by gentamicin-resistantPseudomonas. The pharmacokinetic studies did not show any retention after a ten day treatment with amikacin. Thorough nephrologic and otologic investigations for side-effects did not show any permanent nephrotoxic or ototoxic damage or delayed damage. The results were compared with the clinical and experimental data in the literature and with the results of experimental studies which have not yet been published.

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Literatur

  1. Price, K. K., DeFuria, M. D., Pursiano, T. A. Amikacin, an aminoglycoside with marked activity against antibiotic-resistant clinical isolates. J. Infect. Dis. 154 Suppl. (1976) 249–261.

    Google Scholar 

  2. Knothe, H. In vitro susceptibility of recently isolated gram-negative bacteria to gentamicin, sisomicin, tobramycin, and amikacin. J. Infect. Dis. 154 Suppl. (1976) 271–274.

    Google Scholar 

  3. Daikos, G. K., Kosmidis, J. C., Hamilton-Miller, J. M. T., Brumfitt, W. Amikacin in treatment of infections caused by gram-negative bacteria resistant to gentamicin and other aminoglycosides: clinical and bacteriologic results. J. Infect. Dis. 154 Suppl. (1976) 286–290.

    Google Scholar 

  4. Finland, M., Garner, C., Wilcox, C., Sabath, L. D. Susceptibility of recently isolated bacteria to amikacin in vitro: Comparisons with four other aminoglycoside antibiotics. J. Infect. Dis. 154 Suppl. (1976) 297–307.

    Google Scholar 

  5. Damaso, D., Moreno-Lopez, M., Martinez-Beltran, J., Garcia-Iglesias, M. C. Susceptibility of current clinical isolates ofPseudomonas aeruginosa and enteric gram-negative bacilli to amikacin and other aminoglycoside antibiotics. J. Infect. Dis. 154 Suppl. (1976) 384–390.

    Google Scholar 

  6. Marget, W., Reindke, B., Versmold, H. Use of amikacin in a hospital for children: Microbiological and clinical studies. J. Infect. Dis. 154 Suppl. (1976) 412–419.

    Google Scholar 

  7. Davies, J., Courvalin, P. Mechanisms of resistance to aminoglycosides. Am. J. Med. 62 (1977) 868–877.

    Google Scholar 

  8. Kirby, W. M. M., Turck, M., Fleming, P. C., Louria, D. B., Nelson, J. D.: Round Table: Optimal duration of antibiotic therapy in severe infections. Antimicrob. Agents Chemother. (1967) 183–202.

  9. Guidelines for protocols of new antimicrobial efficacy in urinary tract infections. Food and Drug Administration, Washington, 1975.

  10. Sharp, P. M., Saenz, C. A., Martin, R. R. Amikacin treatment of multiple drug-resistantProteus infections. Antimicrob. Agents Chemother. 5 (1974) 435–543.

    Google Scholar 

  11. Meyer, R. D., Lewis, R. P., Carmalt, E. D., Finegold, S. M. Amikacin therapy for serious gram-negative bacillary infections. Ann. Intern. Med. 83 (1975) 790–799.

    Google Scholar 

  12. Tally, F. P., Louie, T. J., Weinstein, W. M., Bartlett, J. G., Gorbach, S. L. Amikacin therapy for severe gram-negative sepsis. Ann. Intern. Med. 83 (1975) 484–495.

    Google Scholar 

  13. Gilbert, D. N., Eubanks, N., Jackson, J. Comparison of amikacin and gentamicin in the treatment of urinary tract infections. Am. J. Med. 62 (1977) 121–126.

    Google Scholar 

  14. Meyer, R. D., Lewis, R. P., Finegold, S. M. Amikacin therapy for gram-negative septicemia. Am. J. Med. 62 (1977) 127–132.

    Google Scholar 

  15. Tally, F. P., Gorbach, S. L. Amikacin therapy of gram-negative bacteremia. Am. J. Med. 62 (1977) 133–136.

    Google Scholar 

  16. Lode, H., Grunert, K., Koeppe, P., Langmaack, H. Pharmacokinetic and clinical studies with Amikacin, a new aminoglycoside antibiotic. J. Infect. Dis. 154 Suppl. (1976) 316–322.

    Google Scholar 

  17. Federspil, P., Schätzle, W., Tiesler, E. Pharmacokinetics and ototoxicity of gentamicin, tobramycin, and amikacin. J. Infect. Dis. 134 Suppl. (1976) 200–205.

    Google Scholar 

  18. Lane, A. Z., Wright, G. E., Blair, D. C.: Ototoxicity and nephrotoxicity of amikacin. An overview of phase II and phase III experience in the United States. Am. J. Med. (1977) 105–112.

  19. Schurman, D. J., Wheeler, R.: Bone and joint gram-negative infections and amikacin treatment. Am. J. Med. (1977) 160–164.

  20. Smith, C. R., Baughman, K. L., Edwards, C. Q., Rogers, J. F., Lietman, P. S., and the Osler Medical House Staff: A double-blind comparison of gentamicin and amikacin in severe gram-negative infections. Am. J. Med. (1977) 196–203.

  21. Hottendorf, G. H. Comparative ototoxicity (cats) and nephrotoxicity (rats) of amikacin and gentamicin. Am. J. Med. 62 (1977) 97–104.

    Google Scholar 

  22. Federspil, P. Antibiotikaschäden des Ohres. Monographie. Johann Ambrosius Barth Verlag, Leipzig, 1979.

    Google Scholar 

  23. Federspil, P. Über die klinische Ototoxicität des Gentamicins und ihre Reversibilität. Arch. klin. exp. Ohr.-, Nas.- u. Kehlk.-Heilk. 196 (1970) 237–243.

    Google Scholar 

  24. Fee, W. E., Yeager, A. S., Lewiston, N. L., Simmons, F. B., Zachary, V., Lathrop, G. R. Prospective evaluation of aminoglycoside ototoxicity: Tobramycin versus gentamicin: A preliminary report. Curr. Chemother. Proceedings, 10th Intern. Congr. Chemother. Vol. II (1978) 943–945.

    Google Scholar 

  25. Federspil, P. Zur Ototoxizität der Aminoglykosid-Antibiotika. Infection 4 (1976) 239–248.

    Google Scholar 

  26. Black, R. E., Lau, W. K., Weinstein, R. J., Young, L. S., Hewitt, W. L. Ototoxicity of amikacin. Antimicrob. Agents Chemother. 9 (1976) 956–965.

    Google Scholar 

  27. Lerner, S. A., Seligsohn, R., Matz, G. J. Comparative clinical studies of ototoxicity and nephrotoxicity of amikacin and gentamicin. Am. J. Med. 62 (1977) 113–117.

    Google Scholar 

  28. Lewis, R. P., Meyer, R. D., Finegold, S. M. Amikacin therapy of patients with gentamicin-resistant gram-negative bacillary infections. Am. J. Med. 62 (1977) 142–150.

    Google Scholar 

  29. Jackson, G. G. Present status of aminoglycoside antibiotics and their safe, effective use. Clin. Therap. 1 (1977) 371–387.

    Google Scholar 

  30. Lau, W. K., Young, L. S., Black, R. E., Winston, D. J., Linné, S. R., Weinstein, R. J., Hewitt, W. L. Comparative efficacy and toxicity of amikacin/carbenicillin versus gentamicin/carbenicillin in leukopenic patients. Am. J. Med. 62 (1977) 212–219.

    Google Scholar 

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Authors and Affiliations

  1. Hals-Nasen-Ohrenklinik der Universität des Saarlandes, D-6650, Homburg (Saar)

    P. Federspil,  C. Weich &  W. Schätzle

  2. Urologische Universitätsklinik, D-6650, Homburg (Saar)

    K. Schindler &  M. Ziegler

  3. Institut für Hygiene und Mikrobiologie, D-6650, Homburg (Saar)

    E. Tiesler

Authors
  1. P. Federspil
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  2. C. Weich
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  3. W. Schätzle
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  4. K. Schindler
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  5. M. Ziegler
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  6. E. Tiesler
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Federspil, P., Weich, C., Schätzle, W. et al. Zur klinischen Wirksamkeit, Nephrotoxizität und Ototoxizität des Amikacins. Infection 7, 81–87 (1979). https://doi.org/10.1007/BF01641618

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  • DOI: https://doi.org/10.1007/BF01641618

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