The efficacy and safety of isepamicin compared with amikacin in the treatment of intra-abdominal infections.
This multicentre, randomised, open-label, parallel group study compared the efficacy and safety of isepamicin (15 mg/kg once daily) and amikacin (7.5 mg/kg twice daily) when given intravenously in combination with metronidazole to 267 hospitalised adults with intra-abdominal infections. Clinical cure or improvement was achieved in 96.3% (130/135) evaluable patients (efficacy population) in the isepamicin group and 94.3% (66/70) patients in the amikacin group. Bacteriological elimination occurred in 93.3% (126/135) evaluable isepamicin patients and 95.7% (67/170) amikacin patients. there was not statistically significant differences between the groups. Adverse events were reported by 9% of patients in the isepamicin group (16/178) and 10% of patients in the amikacin group (9/89). Events considered to be related to treatment occurred in 6% of patients in both groups. The most frequent adverse events were diarrhoea, nausea and vomiting. Renal problems caused three patients (2 isepamicin, 1 amikacin) to withdraw from the study. Ototoxicity (detected by audiometric testing) occurred in one patient (treated with isepamicin). In conclusion, isepamicin at a dose of 15 mg/kg once daily was shown to be as effective as amikacin (7.5 mg/kg twice daily) in the treatment of intra-abdominal infections in hospitalised adults also treated with metronidazole. Both treatments were well tolerated.
Leal del Rosal
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Clinica del Parque, Chihuahua, Mexico.
D000328:Adult; D000583:Amikacin / Q000009:adverse effects / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002764:Cholecystitis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004926:Escherichia coli; D004927:Escherichia coli Infections; D005260:Female; D006801:Humans; D007710:Klebsiella Infections; D007711:Klebsiella pneumoniae; D008297:Male; D008795:Metronidazole / Q000009:adverse effects / Q000627:therapeutic use; D010538:Peritonitis / Q000188:drug therapy*; D011552:Pseudomonas Infections; D011550:Pseudomonas aeruginosa
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000583:Amikacin