[Amikacin and gentamicin: a controlled comparison (author's transl)]

Area of Science:

• Pharmacology
• Infectious Diseases
• Nephrology

Background:

• Gram-negative bacteria are common causes of urinary tract infections (UTIs).
• Antibiotic resistance to penicillin and cephalosporin necessitates alternative treatments.
• Aminoglycosides like amikacin and gentamicin are used for severe UTIs.

Purpose of the Study:

• To compare the efficacy of amikacin versus gentamicin in treating UTIs.
• To evaluate the impact of renal function on aminoglycoside dosing.
• To assess bacteriological eradication and clinical outcomes.

Main Methods:

• A randomized, double-blind study involving 50 patients (25 per group).
• Patients received amikacin (375 mg/d) or gentamicin (240 mg/d) intramuscularly.
• Dosing was adjusted for impaired renal function.
• Treatment success was based on urine culture results (bacteriological eradication) and white blood cell counts at 3 and 10 days post-treatment.

Main Results:

• Amikacin showed a higher overall success rate compared to gentamicin across various criteria.
• Bacteriological eradication, the primary endpoint, was statistically significantly higher with amikacin.
• Both antibiotics were dosed according to renal function.

Conclusions:

• Amikacin is a more effective treatment option than gentamicin for UTIs caused by gram-negative organisms resistant to other antibiotics.
• The study highlights the importance of appropriate dosing based on renal function for aminoglycosides.
• Amikacin offers a statistically significant advantage in achieving bacterial eradication in UTIs.