Efficacy of sisomicin in patients with cystic fibrosis

Autor: H. Keith, Nancy N. Huang, T. Krefczyk, N. Yasmin, L. Laray-Cuasay
Rok vydání: 1976
Předmět:
Zdroj: Infection. 4:S465-S471
ISSN: 1439-0973
0300-8126
DOI: 10.1007/bf01646985
Popis: Sisomicin was administered to 24 patients with cystic fibrosis who were experiencing acute exacerbation of their pulmonary infections. Five patients were given 3 mg/kg/day i.v. in three divided doses (Group I), five patients were given 5 mg/kg/day i.v. in four divided doses (Group II), and 14 were given 5 mg/kg/day combined with 300–600 mg/kg/day of carbenicillin (Group III). In the latter group, the antibiotic doses were staggered at intervals of 1 to 2 hours. All antibiotics were administered by intravenous drip over 15 to 20 minutes. Bacterial isolates were tested for susceptibility to sisomicin before and after treatment. Serial serum samples and sputum samples were obtained for sisomicin assay. Renal excretion was measured in 24 patients for 8–6 hours following the first intravenous dose. Therapeutic efficacy was evaluated according to a scoring system devised by the authors. All other antibiotic agents taken prior to hospitalization were discontinued, but vitamins, pancreatic enzymes, aerosol therapy and physical therapy were maintained. In addition to clinical, radiological and physiological evaluation, white blood count and differential count, the hemoglobin, platelet count, renal, liver, vestibular and auditory function of all patients were tested before and at the end of therapy and again two weeks after therapy. Serum levels achieved with a dose of 1.2 mg/kg/6 h i.v. (5 mg/kg/day) were well above the MIC and MBC of pathogens found in patients treated in this study. The combination of sisomicin and carbenicillin substantially extended the half-life of sisomicin, improved clinical response and resulted in higher and more prolonged sputum levels, but the mean percentage of improvement was not statistically significant compared with the result with sisomicin alone at 5 mg/kg/day. The mean percentage of clinical improvement was 16.7 % for patients in Group I, 41.7 % for patients in Group II, and 51.1 % for patients in Group III. There was no evidence of increased resistance to sisomicin. The drug was well tolerated by all patients, and all laboratory tests were within normal limits.
Databáze: OpenAIRE
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