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Die antimikrobielle Wirksamkeit von Sisomicin

I: In-vitro-Aktivität von Sisomicin im Vergleich mit Gentamicin, Tobramycin, Amikacin und Kanamycin

Antimicrobial effectiveness of sisomicin

I: In vitro activity of sisomicin compared with gentamicin, tobramycin, amikacin and kanamycin

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Zusammenfassung

Die Aminoglykoside Sisomicin, Gentamicin, Tobramycin, Amikacin und Kanamycin sind gegen Staphylokokken einschließlich penicillinasebildender Stämme gut wirksam. Sisomicin ist Amikacin und Kanamycin überlegen. Mischinfektionen von Staphylokokken mit Enterobacteriaceen bzw. Pseudomonas aeruginosa sind daher eine Indikation für Sisomicin oder andere Aminoglykoside. Infektionen mit E. coli, Enterobacter, sensiblen Klebsiellen und sensiblen Pseudomonaden können mit Sisomicin, Gentamicin oder Tobramycin behandelt werden. Sisomicin hat in diesen Fällen aufgrund der hohen antibakteriellen Aktivität die besten Erfolgschancen. Beim Nachweis dieser Keimarten kann auch Amikacin eingesetzt werden, insbesondere wenn eine Resistenz gegen die anderen Aminoglykoside vorliegt. Nosokomiale Infektionen mit Serratia marcescens sind eine Domäne des Amikacin und Sisomicin. Wegen der hohen Hemmkonzentrationen der Serratien müssen beide Aminoglykoside bei Serratia-Infektionen hoch dosiert werden. Sisomicin hat eine besonders hohe antibakterielle Aktivität gegen Indol-positive Proteusarten wie Proteus vulgaris et morganii, Enterobacter und Gentamicin-sensible Pseudomonas-Stämme. Gegen Infektionen mit Ps. aeruginosa ist Tobramycin das wirksamste Antibiotikum mit bakterizidem Effekt. Bei Gentamicin-resistenten Pseudomonaden mit nicht selten auftretender Parallel-Resistenz zu anderen Aminoglykosiden ist Amikacin das Mittel der Wahl. Die niedrige Resistenzrate des Sisomicin von 7,6% bei 370 Bakterienstämmen wird mit 0,6% nur von Amikacin unterboten (Resistenz gegen Tobramycin 11,4%, Gentamicin 13,2% und Kanamycin 42,4%). Die niedrige Resistenzrate und die hohe antimikrobielle Aktivität sind wesentliche Vorzüge des Sisomicin.

Summary

The aminoglycosides sisomicin, gentamicin, tobramycin, amikacin and kanamycin are highly active against staphylococci including the penicillinase-positive strains. Sisomicin is more effective than amikacin and kanamycin. Mixed infections with staphylococci and Enterobacteriaceae or Pseudomonas aeruginosa are thus on indication for treatment with sisomicin or other aminoglycosides. Infections with E. coli, Enterobacter, susceptible Klebsiella, and susceptible Pseudomonas strains can be treated with sisomicin, gentamicin or tobramycin. In such cases sisomicin is the most effective antibiotic because of its high antimicrobial activity. In infections with these organisms amikacin can also be used for treatment especially if there is resistance to other aminoglycosides. In hospital-acquired infections with Serratia marcescens amikacin and sisomicin are the drugs of choice. Both aminoglycosides have to be given in high doses in infections with Serratia because of the high inhibitory concentration for Serratia. Sisomicin demonstrates a high antimicrobial activity particularly against indole-positive Proteus species such as Proteus vulgaris and Proteus morganii, Enterobacter, and gentamicin-sensitive Pseudomonas strains. In infections with Pseudomonas aeruginosa tobramycin is the most effective bactericidal antibiotic. Amikacin is the drug of choice against gentamicin-resistant Pseudomonas strains which are also not infrequently resistant to other aminoglycosides. The low proportion of resistance to sisomicin of 7,6% in 370 organisms is only exceeded by amikacin with a rate of 0,6% (resistance to tobramycin 11,4%, gentamicin 13,2% and kanamycin 42,4%). The low rate of resistance and the high antimicrobial activity are essential advantages of sisomicin.

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  1. Institut für Medizinische Mikrobiologie und Immunologie, Universitäts-Krankenhaus Eppendorf, Martinistr. 52, D-2000, Hamburg 20

    H. -H. Schassan

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  1. H. -H. Schassan
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Schassan, H.H. Die antimikrobielle Wirksamkeit von Sisomicin. Infection 4, 35–41 (1976). https://doi.org/10.1007/BF01638346

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