[Sisomicin versus gentamicin. A comparison of antibacterial and pharmacokinetic properties (author's transl)]

[Pharmacokinetic and clinical studies with sisomicin in paediatrics (author's transl)]

Pharmakokinetic and clinical investigations were carried out with sisomicin, one of the newer aminoglycoside antibiotics, in 40 children aged from seven days to ten years. Serum concentrations were determined in 35 children 1/2, 1, 2, 4 and 6 hours after i. m. injection of 1.0 mg sisomicin/kg body weight. The average peak serum levels were 2.48 mg/l in children under three months and 3.58 mg/l in children between seven months and ten years. Renal elimination in newborns is delayed in comparison to older infants and children; the distribution volume of the central compartment diminishes with increasing age. The effect of these two counteracting tendencies is that renal clearance remains constant in the age groups investigated, however the frequency of drug administration must be adjusted according to age. During an average treatment period of ten days adequate serum concentrations between 3.1 mg/l and 6.2 mg/l one hour after injection could be achieved with dosages adjusted to age and body weight. Clinical results were good: 18 out of 20 children could be cured clinically, and 20 out of 21 isolated infectious agents were eliminated. There were no problems in local and systemic tolerance.

[Experience with sisomicin in pediatrics (author's transl)]

Sisomicin, an aminoglycoside antibiotic, is especially effective against Escherichia coli, Klebsiella, Enterobacter, Citrobacter, Serratia, indole-positive and indole-negative Proteus species, Pseudomonas aeruginosa, Salmonella and Staphylococcus aureus. It has a bactericidal action. Although sisomicin is similar to the other aminoglycoside antibiotics, there is not complete cross-resistance to them. Our own pharmacokinetic investigations showed that a dose of 2--3 mg/kg body weight of sisomicin twice daily is necessary in the neonatal period. Infants should be given 2.5 mg/kg body weight three times daily, and school children 1.5--20 mg/kg body weight, likewise three times daily. Excretion of sisomicin in the urine is lower in children than in adults, amounting within 24 hours to only 10--20% in newborns, and 30--40% in school-children. Sisomicin induces excretion of some enzymes in higher quantities from the tubular part of the kidneys, especially alaninaminopeptidase. A report is given on 58 patients, especially newborns and prematures, who were treated for about seven days with sisomicin. The results obtained with a wide variety of infections (such as omphalitis, aspiration of amniotic fluid with broncho-pneumonia, phlegmons of the galea, and also pyelonephritis and mucoviscidosis with pulmonary complications) can be described as good, with a success rate of 85%. On only seven occasions were insignificant transitory side-effects, such as slight increase in transaminases, toxic-allergic exanthema and pain in the region in injection, observed.