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Antimicrobial Agents and Chemotherapy, December 2000, p. 3285-3287, Vol. 44, No. 12
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Early Bactericidal Activity of Paromomycin (Aminosidine) in Patients with Smear-Positive Pulmonary Tuberculosis

P. R. Donald,1,* F. A. Sirgel,2 T. P. Kanyok,3 L. H. Danziger,3 A. Venter,2 F. J. Botha,4 D. P. Parkin,4 H. I. Seifart,4 B. W. Van de Wal,5 J. S. Maritz,6 and D. A. Mitchison7

Departments of Pediatrics and Child Health,1 Pharmacology,4 and Internal Medicine,5 Tygerberg Hospital and The University of Stellenbosch, Tygerberg, and National Tuberculosis Research Programme2 and MRC Centre for Epidemiological Research,6 Cape Town, South Africa; Department of Pharmacy Practice Colleges of Pharmacy and Medicine, University of Illinois at Chicago, Chicago, Illinois3; and Department of Microbiology, St. George's Hospital Medical School, London, United Kingdom7

Received 4 April 2000/Returned for modification 27 June 2000/Accepted 25 August 2000

The early bactericidal activity of the aminoglycoside paromomycin (aminosidine) in doses of 7.5 and 15 mg/kg of body weight was measured in 22 patients with previously untreated smear-positive pulmonary tuberculosis. The fall in log10 CFU per milliliter of sputum per day during the first 2 days of treatment for 7 patients receiving a paromomycin dosage of 7.5 mg/kg/day was 0.066, with a standard deviation (SD) of 0.216 and confidence limits from -0.134 to 0.266, and that for 15 patients receiving 15 mg/kg/day was 0.0924, with an SD of 0.140 and confidence limits from 0.015 to 0.170. The difference between the mean and zero was not significant for the 7.5-mg/kg dose group but was significant for the 15-mg/kg dose group (t = 2.55, P = 0.023). Since paromomycin has no cross-resistance with streptomycin and has no greater toxicity than other aminoglycosides, these results suggest that it has the potential to substitute for streptomycin in antituberculosis regimens and may be a particularly valuable addition to the drug armamentarium for the management of multidrug-resistant tuberculosis.

* Corresponding author. Mailing address: Department of Paediatrics and Child Health, Faculty of Medicine, P.O. Box 19063, Tygerberg, 7505, South Africa. Phone: (021) 9389506. Fax: (021) 9389138. E-mail: aec1{at}gerga.sun.ac.za.

Antimicrobial Agents and Chemotherapy, December 2000, p. 3285-3287, Vol. 44, No. 12
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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