ISEPAMICIN ONCE-DAILY PLUS CEFTRIAXONE VERSUS AMIKACIN PLUS CEFTRIAXONE IN FEBRILE NEUTROPENIC PATIENTS

Isepamicin is a new aminoglycoside with in-vitro activity superior to amikacin. It is a poor substrate for the 6'-aminoacetyltransferase-I e nzyme which inactivates amikacin and therefore organisms possessing th is enzyme are not resistant to isepamicin. The aim of this study was t o compare the efficacy and safety of co-administration of isepamicin o nce daily plus ceftriaxone to amikacin twice daily plus ceftriaxone in febrile neutropenic cancer patients. Febrile episodes in 235 patients (156 in isepamicin group and 79 in amikacin group) were treated in th is study. They occurred in 218 different patients. Fifteen patients we re enrolled twice and one three times. Response rates to the two treat ment regimens for microbiologically documented episodes, clinically do cumented episodes and further unexplained fever were similar. Toleranc e of the treatment regimens, as measured by serum creatinine levels, h ypoaccousia and cutaneous allergy was also similar in both treatment g roups. In conclusion, isepamicin given once daily when combined with c eftriaxone in the treatment of febrile episodes in neutropenic cancer patients was as effective and no more toxic than amikacin.