Details

Autor(en) / Beteiligte

• Miura, Katsuhiro
• Nakagawa, Masaru
• Takahashi, Hiromichi
• Uchino, Yoshihito
• Kodaira, Hitomi
• Iriyama, Noriyoshi
• Sakagami, Masashi
• Ohtake, Shimon
• Kobayashi, Sumiko
• Hojo, Atsuko
• Kurita, Daisuke
• Kobayashi, Yujin
• Kusuda, Machiko
• Hirabayashi, Yukio
• Hatta, Yoshihiro
• Takei, Masami

Titel

Clinical efficacy and safety of arbekacin for high-risk infections in patients with hematological malignancies

Ist Teil von

• International journal of hematology, 2016-03, Vol.103 (3), p.334-340

Ort / Verlag

Tokyo: Springer Japan

Erscheinungsjahr

2016

Link zum Volltext

Quelle

SpringerLink

Beschreibungen/Notizen

• We performed a clinical trial to investigate the efficacy and safety of arbekacin (ABK), a unique aminoglycoside with activity against methicillin-resistant Staphylococcus aureus (MRSA), in patients with hematological malignancies complicated by high-risk infections. ABK was administered intravenously at a dose of approximately 5 mg/kg with various broad-spectrum β-lactams, followed by therapeutic drug monitoring (TDM). A total of 54 febrile or infectious episodes were registered, and TDM was performed in 44 (81 %) cases. The absolute neutrophil count was below 500/μl in 49 (91 %) cases, and cytotoxic chemotherapy was being administered in 47 (87 %) cases. Before initiation of ABK, 52 (96 %) patients had received fluoroquinolones ( n  = 37) and/or broad-spectrum β-lactams (n  = 34). There were 10 cases of documented infections including one of MRSA pneumonia, and 44 cases of febrile neutropenia. The efficacy at the end of treatment was 80 % for all patients, and efficacy was significantly higher in patients attaining maximum concentrations ≥16 µg/ml or receiving TDM-guided dose-adjustment of ABK ( n  = 19, 95 vs. 71 %, P  = 0.039). Renal toxicity was observed in six cases (11 %) but was generally acceptable. This study demonstrated that TDM-guided ABK administration may be applicable under limited conditions for patients with hematological malignancies.