Isepamicin once daily plus ceftriaxone versus amikacin plus ceftriaxone in febrile neutropenic patients

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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

R Herbrecht1, D Blaise, D Espinouse

  • 1Service d'Onco-Hématologie, Hôpital de Hautepierre, France.

Journal of Chemotherapy (Florence, Italy)
|June 1, 1995
PubMed

Insights

Isepamicin, an aminoglycoside antibiotic, demonstrated comparable efficacy and safety to amikacin when combined with ceftriaxone for treating febrile neutropenic cancer patients. This new antibiotic offers a promising alternative for managing infections in this vulnerable population.

Area of Science:

  • Pharmacology and Infectious Diseases
  • Oncology and Hematology

Background:

  • Aminoglycoside antibiotics are crucial in treating severe bacterial infections, but resistance mechanisms can limit their effectiveness.
  • Isepamicin exhibits superior in vitro activity compared to amikacin and is less susceptible to common aminoglycoside-inactivating enzymes.
  • Febrile neutropenia in cancer patients presents a significant clinical challenge requiring effective and safe antimicrobial strategies.

Purpose of the Study:

  • To compare the efficacy and safety of isepamicin once daily plus ceftriaxone versus amikacin twice daily plus ceftriaxone in febrile neutropenic cancer patients.

Main Methods:

  • A prospective study involving 235 febrile episodes in cancer patients (156 treated with isepamicin, 79 with amikacin).
  • Both treatment groups received ceftriaxone as a companion antibiotic.
  • Efficacy was assessed by response rates for microbiologically documented, clinically documented, and unexplained fever episodes.
  • Safety was evaluated by monitoring serum creatinine, hearing loss (hypoacusis), and skin allergies.

Main Results:

  • Similar response rates were observed between the isepamicin and amikacin groups across all fever categories.
  • The incidence of adverse events, including renal toxicity (serum creatinine), ototoxicity (hypoacusis), and cutaneous allergy, was comparable between the two treatment regimens.
  • Isepamicin showed similar efficacy and safety profiles to amikacin in this patient population.

Conclusions:

  • Once-daily isepamicin combined with ceftriaxone is a viable and effective treatment option for febrile episodes in neutropenic cancer patients.
  • Isepamicin offers a comparable safety profile to amikacin, suggesting it is a suitable alternative, particularly given its in vitro advantages.
  • The study supports the use of isepamicin as an effective and safe therapeutic agent in managing febrile neutropenia in oncology settings.

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