isepamicin and Bacterial-Infections

Topics: Bacteria; Bacterial Infections; Clinical Trials as Topic; Drug Resistance, Microbial; Gentamicins; Humans; Tissue Distribution

The efficacy and safety of isepamicin at 7.5 mg/kg i.v. q 12 h was prospectively compared with that of amikacin at the same dose for the treatment of febrile neutropenic children with malignancies. Thirty-nine patients were enrolled in the study; 25 received isepamicin and 14 amikacin. Clinical and bacteriological response rates were 100% for both groups. No adverse events occurred. Median peak serum levels were 19.7 mg/l for isepamicin and 19.20 mg/l for amikacin. Median trough serum levels were 0.72 mg/l for isepamicin and 0.68 mg/l for amikacin. It was concluded that isepamicin was as effective and safe as amikacin for the treatment of febrile neutropenic children with malignancies, and might be used in areas where resistance to other aminoglycosides is a problem.

Topics: Amikacin; Anti-Bacterial Agents; Bacterial Infections; Child; Child, Preschool; Drug-Related Side Effects and Adverse Reactions; Fever; Gentamicins; Humans; Male; Neoplasms; Neutropenia; Random Allocation

A multicentre, non-comparative study evaluated the efficacy and safety of the new aminoglycoside isepamicin in hospitalised patients with various infections. Isepamicin was administered once daily with the daily dosage stratified according to the severity of infection: 15 mg/kg isepamicin for severe potentially systemic infections (53 patients) or 8 mg/kg isepamicin for less severe and localised infections (56 patients). The largest groups of patients had urinary tract infection (n = 54) or lower respiratory tract infection (n = 31); smaller numbers of patients were enrolled with skin and soft tissue infections (n = 9), intra-abdominal infections (n = 8) or obstetric and gynaecological infections (n = 7). In the patients receiving 15 mg/kg isepamicin, clinical cure or improvement occurred in 19/21 patients with lower respiratory tract infections, 8/13 patients with urinary tract infections, 6/6 patients with skin infections, 5/6 patients with intra-abdominal infections and 6/7 patients with obstetric gynaecological infections. In the patients receiving 8 mg/kg isepamicin, 40 out of 41 patients with urinary tract infections were considered cured or improved as were 8/10 patients with lower respiratory tract infections, 1/3 patients with skin infections and 1/2 patients with intra-abdominal infections. Nine per cent of patients reported at least on adverse event during the study. Two patients (one from each dosage group) discontinued treatment because of adverse events, respiratory disorder and erythematous rash, but neither event was considered to be severe of life threatening No patients had evidence of ototoxicity by pure-tone audiometry and no patients had potentially significant increases in serum creatinine which were considered to be treatment related. The results of this study indicate that treatment with isepamicin once daily is effective and well tolerated in hospitalised adults with various infections.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Infections; Drug Administration Schedule; Female; Genital Diseases, Female; Gentamicins; Humans; Male; Middle Aged; Respiratory Tract Infections; Skin Diseases, Bacterial; Urinary Tract Infections

The efficacy and safety of isepamicin 7.5 mg/kg of body weight twice daily or amikacin the same dosage regimen for the treatment of various infections in neutropenic and non-neutropenic paediatric patients were compared in a prospective randomised trial. In total, 306 patients were enrolled and received at least one dose of randomised treatment (204 isepamicin, 102 amikacin: intent-to-treat population); 181 patients satisfied all criteria for evaluability (120 isepamicin, 61 amikacin: efficacy population). Clinical cure or improvement rates in the isepamicin and amikacin groups were: intent-to-treat population, 188/204 (92%) and 94/102 (92%), respectively; efficacy population, 117/120 (98%) and 58/61 (95%), respectively. The bacteriological elimination rate (efficacy population) in the isepamicin and amikacin treatment groups was 75/76 (99%) vs 35/38 (92%). Nephrotoxicity, defined as an increase in serum creatinine of 0.5 mg/dL or > or = 44.2 mumol/L from baseline, occurred in 4/187 (2%) and 1/191 (1%) children treated with isepamicin and amikacin, respectively. Definite ototoxicity at the > or = 20 dB threshold occurred in 3 (1 isepamicin and 2 amikacin) out of 56 children evaluated with at least two audiograms. Thus isepamicin was as effective and as well tolerated as amikacin in the treatment of various infections in paediatric patients.

Topics: Adolescent; Amikacin; Anti-Bacterial Agents; Bacterial Infections; Child; Child, Preschool; Drug Administration Schedule; Enterococcus faecalis; Escherichia coli Infections; Female; Gentamicins; Humans; Infant; Infant, Newborn; Klebsiella Infections; Klebsiella pneumoniae; Male; Staphylococcal Infections; Staphylococcus epidermidis; Streptococcal Infections

Topics: Bacteria; Bacterial Infections; Clinical Trials as Topic; Drug Resistance, Microbial; Gentamicins; Humans; Tissue Distribution

To evaluate the combination of isepamicin and levofloxacin in the prophylaxis of infectious complications associated with prostate biopsy (PBX).. A total of 586 patients who underwent transrectal PBX in a single center were included in this retrospective analysis. They received 400 mg isepamicin once just before PBX plus 300 mg oral levofloxacin each day for three days as a rule. Clinical and laboratory data were evaluated.. A total of three (0.51%) patients presented a febrile complication after PBX. All of them were diagnosed as acute prostatitis. Serum white blood cell count and C-reactive protein in the 131 patients whose laboratory data were available for statistical analyses did not rise significantly after PBX.. Isepamicin plus fluoroquinolone can be considered a valuable regimen for antibiotic prophylaxis of PBX.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Biopsy; Drug Therapy, Combination; Gentamicins; Humans; Levofloxacin; Male; Ofloxacin; Prostate; Prostatitis; Rectum; Retrospective Studies; Risk Factors; Ultrasound, High-Intensity Focused, Transrectal

isepamicin is a new aminoglycoside with a spectrum of activity similar to amikacin with an advantage of possessing a high level of stability against different aminoglycoside modifying enzymes. the in vitro susceptibility of nosocomial isolates obtained from patients admitted to the All India Institute of Medical Sciences, New Delhi during October-December, 1999 was tested against isepamicin and compared with other aminoglycosides.. a total of 251 clinical isolates were studied which included Escherichia coli 87, Klebsiella pneumoniae 54, Pseudonomas aeruginosa 38, Staphylococcus aureus 27 (methicillin resistant S. aureus 15, methicillin sensitive S. aureus 12), Acinetobacter species 26, Enterobacter aerogenes 9, Proteus mirabilis 5, Proteus vulgaris 2, and Citrobacter species 3. The minimum inhibitory concentration (MIC) against isepamicin and other aminoglycosides including amikacin, gentamicin, netilmicin and tobramycin was done using NCCLS guidelines. The cut-off values of isepamicin were used as that of amikacin.. we found that overall 153 nosocomial isolates were sensitive to isepamicin as compared to 95 for amikacin in this hospital. Isepamicin showed a superior in vitro activity compared to the other aminoglycosides tested.. isepamicin can be a good alternative in multidrug resistant nosocomial isolates in hospitals where amikacin resistance is emerging.

Topics: Anti-Bacterial Agents; Bacterial Infections; Cross Infection; Drug Resistance, Bacterial; Gentamicins; Humans; In Vitro Techniques; India; Microbial Sensitivity Tests

In order to evaluate antibacterial activities of combination uses of isepamicin (ISP) and beta-lactams in vitro, minimum inhibitory concentrations (MICs) these drugs were examined singly and in combination against clinically isolated Staphylococcus aureus. The results are summarized as follows; 1. MICs of ISP + cefazolin (CEZ), ISP + cefotiam (CTM) and ISP + flomoxef (FMOX) were low and the activities against methicillin (DMPPC)-susceptible S. aureus (MSSA) were dependent on the concentration of ISP. Combined effects were observed when the concentrations of ISP were at sub-MIC levels (1/2 approximately 1/4 concentrations). 2. MICs of ISP + CEX, ISP + CTM, ISP + FMOX, ISP + imipenem and ISP + panipenem were low and the activities against DMPPC-resistant S. aureus (MRSA) were dependent on the concentration of ISP, and were similar to those against MSSA. Combined effects were observed when the concentrations of ISP were at sub-MIC levels of ISP. Lower MIC50 or MIC90 was observed at ISP concentrations of 4 approximately 16 micrograms/ml. 3. The blood Cmax of ISP exceeded 20 micrograms/ml at one-time administration of ISP 400 mg, and these results suggested that antibacterial activities of combination uses of ISP and beta-lactams was clinically effective against MRSA infections.

Topics: Anti-Bacterial Agents; Bacterial Infections; Cefazolin; Cefotiam; Cephalosporins; Dose-Response Relationship, Drug; Drug Therapy, Combination; Gentamicins; Humans; Methicillin Resistance; Staphylococcus aureus

Topics: Bacterial Infections; Cystitis; Gentamicins; Humans; Microbial Sensitivity Tests; Respiratory Tract Infections

The object of this work is to study in neutropenic mice the in vivo postantibiotic effect (PAE) of isepamicin, a new aminoglycoside, gentamicin and netilmicin on Staphylococcus aureus and Escherichia coli and in vivo killing kinetics using two different schedules (A and B) of isepamicin and gentamicin administration against S. aureus: (A) at time zero and every hour up to the 7th or 9th hour and (B) two doses only, at time zero and at the end of the PAE. The PAE of the three aminoglycosides was long (3-5 h), showing that of isepamicin to be the largest, especially on S. aureus. Both A and B treatment models show the same effectiveness for the two tested drugs. These results support the idea that the major significance of the PAE is in its application to dosing regimens.

Topics: Animals; Bacterial Infections; Disease Models, Animal; Escherichia coli; Female; Gentamicins; Mice; Mice, Inbred BALB C; Microbial Sensitivity Tests; Netilmicin; Neutropenia; Staphylococcus aureus; Thigh; Time Factors

In vitro interactions between aztreonam (AZT) and 8 other antibiotics were studied using the agar dilution checkerboard technique against 88 clinical isolates of Escherichia coli, Proteus vulgaris, Serratia marcescens and Pseudomonas aeruginosa. Combinations of AZT with 8 other antibiotics were generally additive or indifferent. Synergism was occasionally seen against S. marcescens or P. aeruginosa with AZT plus isepamicin (ISP). Antagonism was observed only between AZT and latamoxef against P. vulgaris. In a phase-contrast microscopic study, synergistic effects between AZT and aspoxicillin or ISP were confirmed against E. coli 177 and P. aeruginosa 15846. AZT in combination with ISP demonstrated a synergy against experimental urinary tract infection in mice caused by P. aeruginosa 15846. We believe that combinations of several antibiotics with AZT should be considered for initial therapy of infections because synergism and additive action were observed and antagonism was rarely found in our study.

Topics: Amoxicillin; Animals; Aztreonam; Bacterial Infections; Drug Resistance, Microbial; Drug Synergism; Drug Therapy, Combination; Escherichia coli; Female; Gentamicins; Mice; Microscopy, Phase-Contrast; Moxalactam; Proteus vulgaris; Pseudomonas aeruginosa; Serratia marcescens

Topics: Bacterial Infections; Gentamicins; Humans; Infusions, Intravenous