Comparison of amikacin and tobramycin in the treatment of infection in patients with cancer.
Two new aminoglycoside antibiotics, tobramycin and amikacin, were compared in a randomized study of the treatment of infections in patients with cancer. For the identified infections, the response rate for tobramycin was 60% and for amikacin was 64%. Pneumonia, urinary tract infection, and septicemia were the most frequent infections. Most (78%) of the identified pathogens were gram-negative bacilli; Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa were the most frequently isolated organisms. When only infections due to gram-negative bacilli were considered, 67% responded to tobramycin and 69% responded to amikacin. All infections except pneumonias had at least a 50% response rate to either antibiotic. The major form of toxicity of both antibiotics was azotemia and occurred in 22% of cases treated with tobramycin and in 20% treated with amikacin. Tobramycin and amikacin are equally effective in the treatment of gram-negative infections and have similar toxicity.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000583:Amikacin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy; D005260:Female; D006801:Humans; D007612:Kanamycin / Q000031:analogs & derivatives*; D007710:Klebsiella Infections / Q000188:drug therapy; D007711:Klebsiella pneumoniae / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011014:Pneumonia / Q000188:drug therapy* / Q000209:etiology; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D018805:Sepsis / Q000188:drug therapy* / Q000209:etiology; D014031:Tobramycin / Q000627:therapeutic use*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents; D007612:Kanamycin; D000583:Amikacin; D014031:Tobramycin