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Isepamicin versus amikacin for the treatment of acute pyelonephritis in children
D A Kafetzis1, H C Maltezou, M Mavrikou
1Second Department of Pediatrics, University of Athens, P. and A. Kyriakou Children's Hospital, Athens, Greece. kafetzis@ath.forthnet.gr
Insights
Isepamicin and amikacin showed equal efficacy and safety in treating pediatric pyelonephritis. This study suggests isepamicin as a viable alternative for children
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
- Pharmacology
Background:
- Pyelonephritis is a serious kidney infection in children.
- Aminoglycosides are commonly used for treatment, but resistance is a growing concern.
- Comparing novel aminoglycosides like isepamicin to established ones like amikacin is crucial.
Purpose of the Study:
- To compare the efficacy and safety of isepamicin versus amikacin in treating pediatric pyelonephritis.
- To evaluate clinical and bacteriological outcomes.
- To assess serum drug levels and adverse events.
Main Methods:
- A comparative study involving 16 children diagnosed with pyelonephritis.
- Patients received either isepamicin or amikacin intravenously at 7.5 mg/kg every 12 hours for 10-14 days.
- Urine cultures were analyzed, and clinical/bacteriological responses were monitored.
Main Results:
- All patients (100%) in both the isepamicin and amikacin groups achieved successful treatment.
- Escherichia coli was the causative pathogen in all cases.
- No adverse events were reported in either treatment group, with comparable peak and trough serum levels observed.
Conclusions:
- Isepamicin demonstrated equivalent efficacy and safety to amikacin in treating pediatric pyelonephritis.
- Isepamicin presents a promising alternative, particularly in regions with high resistance rates to other aminoglycosides.
- Further research may explore isepamicin's role in managing multidrug-resistant infections.
Abstract:
In this study we compared the efficacy and safety of isepamicin versus amikacin at a dose of 7.5 mg/kg i.v. q12h for 10-14 days in children with pyelonephritis. Sixteen children were enrolled in the study; ten received isepamicin and six amikacin. Urine cultures grew Escherichia coli in all patients. All patients were treated successfully with either isepamicin or amikacin. Clinical and bacteriological response rates were 100% for both groups. No adverse events occurred. Peak serum levels ranged from 9.05 to 30.70 mg/l (median: 16.165) and from 12.20 to 25.90 mg/l (median: 19.05) for isepamicin and amikacin, respectively. Trough serum levels ranged from 0.11 to 3.20 mg/l (median: 0.75) and from 0.1 to 2.1 mg/l (median: 0.655), respectively. Isepamicin was shown to be as effective and safe as amikacin in the treatment of children with pyelonephritis and might prove an advantageous alternative in areas with high incidence of resistance to other aminoglycosides.