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Background & objectives : Isepamicin is a new aminoglycoside with a spectrum of activity similar to amikacin with an advantage of possessing a high level of stability against different aminoglycoside modifying enzymes. The in vitro susceptibility of nosocomial isolates obtained from patients admitted to the All India Institute of Medical Sciences, New Delhi during October-December, 1999 was tested against isepamicin and compared with other aminoglycosides.
Methods : A total of 251 clinical isolates were studied which included Escherichia coli 87, Klebsiella pneumoniae 54, Pseudonomas aeruginosa 38, Staphylococcus aureus 27 (methicillin resistant S. aureus 15, methicillin sensitive S. aureus 12), Acinetobacter species 26, Enterobacter aerogenes 9, Proteus mirabilis 5, Proteus vulgaris 2, and Citrobacter species 3. The minimum inhibitory concentration (MIC) against isepamicin and other aminoglycosides including amikacin, gentamicin, netilmicin and tobramycin was done using NCCLS guidelines. The cut-off values of isepamicin were used as that of amikacin.
Results : We found that overall 153 nosocomial isolates were sensitive to isepamicin as compared to 95 for amikacin in this hospital. Isepamicin showed a superior in vitro activity compared to the other aminoglycosides tested.
Interpretation & conclusions : Isepamicin can be a good alternative in multidrug resistant nosocomial isolates in hospitals where amikacin resistance is emerging.
Key words Aminoglycosides - antibiotic resistance - isepamicin - nosocomial infection
Amikacin is the most widely used aminoglycoside in empirical antibiotic therapy. Recently, there has been an emergence of amikacin resistant strains harboring a specific acetyl transferase, which inactivates amikacin'. Isepamicin (1-N-HAPAgentamicin B) is a novel aminoglycoside which possesses a high level of stability to a broad spectrum of aminoglycoside inactivating enzymes. The spectrum of isepamicin is similar to that of amikacin. Like other aminoglycosides, it acts by binding bacterial ribosomes resulting in misreading of the mRNA and inhibition of bacterial protein synthesis. The spectrum of activity of isepamicin includes all species of Enterobacteriaceae, Pseudomonas, Acinetobacter and Staphylococci1.
It was...