Korean J Med.  2003 Aug;65(2):239-244.

Clinical Efficacy and Safety with Arbekacin for Methicillin-Resistant Staphylococcus aureus (MRSA) Infections

• Kim TH
• Choo EJ
• Lee MS
• Kim NJ
• Woo JH
• Ryu J
• Chang MS
• Yum YK

Abstract

BACKGROUND: Arbekacin was introduced to treat methicillin-resistant Staphylococcus aureus (MRSA) infection. It is an aminoglycoside with proven in vitro activity against MRSA strains. Pharmacokinetic advantages such as concentration-dependant bactericidal activity, prolonged post-antibiotic effect are its feature of aminoglycoside like others. But there are only few clinical data of this new kind of antibiotics outside of Japan, the first country approved its use against MRSA infections. We studied the clinical and bacteriological efficacy and safety of arbekacin in the treatment of infections caused by MRSA.
METHODS
During the period between December 2001 and October 2002, we prospectively enrolled 21 patients with culture proven MRSA infection and evaluated the clinical and bacteriological efficacy and adverse events of arbekacin. Patients were treated with arbekacin sulphate 100 mg intravenously twice daily for 14 days.
RESULTS
Patients were included if they had signs and symptoms of active MRSA infection including bacteremia, soft tissue infection, urinary tract infection, pneumonia etc. A total of 21 patients with MRSA infection were enrolled. Four patients experienced adverse events; 3 nephrotoxicities, 1 hepatotoxicity. One of them with elevated creatinine was unable to continue the study. Efficacy were evaluated on 19 patients with duration of arbekacin longer than 9 days. A favorable bacteriological response (eradicated or presumed eradicated) occurred in 13 (68.5%) patients.
CONCLUSION
Although this clinical study was limited in number and in proper randomization, arbekacin alone was less effective than combination therapy with glycopeptides for the treatment of MRSA infection. However, our limited data suggested the efficacy of arbekacin alone for the treatment which needs shorter duration. The combination treatment of arbekacin and glycopeptide appeared to be less nephrotoxic than other aminoglycosides. The combination therapy of arbekacin and glycopeptide appeared to be less nephrotoxic than other aminoglycoside.

Keyword

Arbekacin; Efficacy; MRSA (methicillin-resistant Staphylococcus aureus)

MeSH Terms

Aminoglycosides
Anti-Bacterial Agents
Bacteremia
Creatinine
Glycopeptides
Humans
Japan
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Pneumonia
Prospective Studies
Random Allocation
Soft Tissue Infections
Urinary Tract Infections
Aminoglycosides
Anti-Bacterial Agents
Creatinine
Glycopeptides