A Prospective Randomised Comparison of Cefotaxime vs. Netilmicin vs. Cefotaxime plus Netilmicin in the Treatment of Hospitalised Patients with Serious Sepsis
| Autor: | Roger Sage, Paul Noone, Bernadette Nazareth |
|---|---|
| Rok vydání: | 1987 |
| Předmět: |
Adult
Microbiology (medical) medicine.medical_specialty Klebsiella Cefotaxime Micrococcaceae Adolescent medicine.drug_class Urinary system Antibiotics Sepsis Random Allocation Internal medicine otorhinolaryngologic diseases medicine Humans Netilmicin Antibacterial agent Cross Infection General Immunology and Microbiology biology business.industry Enterobacteriaceae Infections Bacterial Infections General Medicine Staphylococcal Infections medicine.disease biology.organism_classification Surgery carbohydrates (lipids) Infectious Diseases Drug Therapy Combination business medicine.drug |
| Zdroj: | Scandinavian Journal of Infectious Diseases. 19:331-337 |
| ISSN: | 1651-1980 0036-5548 |
| DOI: | 10.3109/00365548709018479 |
| Popis: | 93 patients were enrolled into a prospective randomised study to determine the efficacy and safety of netilmicin, cefotaxime or their combination in the treatment of sepsis caused by susceptible strains of Enterobacteriaceae or staphylococci. 83 patients were evaluable for safety, 74 for clinical efficacy and 63 for microbiological response including 36 patients (57%) with positive blood cultures. There were significantly more clinical failures with cefotaxime than with netilmicin even when urinary tract sepsis was excluded. Microbiological failures occurred more frequently in the cefotaxime arm and were associated with Klebsiella and Enterobacter spp. Four cefotaxime failures were subsequently successfully treated with netilmicin. More mixed infections were however enrolled by chance into the cefotaxime arm. The statistical difference between netilmicin and cefotaxime is not significant if mixed infections are excluded. There was no difference in efficacy between the netilmicin and combination groups although superinfection was seen in the latter group. The incidence of nephrotoxicity was greater in the netilmicin group but not significantly so. Only one minor case of ototoxicity was detected in the 41 patients receiving netilmicin who had serial audiograms. The results suggest that netilmicin is a more effective agent than cefotaxime for treating life-threatening infections with susceptible Enterobacteriaceae or staphylococci particularly with infections in non-urinary tract sites. If dosage of netilmicin is closely monitored by measuring serum concentrations, toxicity is minimal. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|