ISEPAMICIN VERSUS AMIKACIN IN THE TREATMENT OF URINARY-TRACT INFECTION

In a series of three prospective, randomised, multicentre trials, isep amicin (15 mg/kg or 8 mg/kg once daily depending on severity of infect ion) was compared with amikacin (7.5 mg/kg twice daily) in a total of 252 adult hospitalised patients (mean age 51-54 years) with urinary tr act infection. Pretreatment pathogens included Escherichia coli, which was isolated from approximately 50% of patients, and Pseudomonas aeru ginosa, which was isolated from approximately 10% of patients with sev ere infections. The most commonly occurring primary diagnoses were com plicated pyelonephritis, uncomplicated pyelonephritis and complicated lower urinary tract infection. For the patients included in the effica cy population, elimination of the pathogens occurred, for all infectio ns combined, in 92/101 (91%) patients in the isepamicin group and 51/5 5 (93%) patients in the amikacin group. Adverse events occurred in 15% of isepamicin patients and 6% of amikacin patients. Ototoxicity at th e greater than or equal to 20 dB threshold was noted in one isepamicin and two amikacin patients, but none of these patients had associated clinical signs of auditory or vestibular toxicity. Four isepamicin and four amikacin patients had potentially significant increases in serum creatinine indicative of possible nephrotoxicity.