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Clinical and bacteriological efficacy, and practical aspects of amikacin given once daily for severe infections
G Beaucaire1, O Leroy, C Beuscart
1Intensive Care and Infectious Diseases Unit, University of Lille, Centre Hospitalier Dron, Tourcoing, France.
Abstract:
In a multicentre non-randomized open prospective study, 124 patients hospitalized in medical infectious disease or intensive care units, with severe community and hospital-acquired bacterial infections were treated with 15 mg/kg body weight amikacin in a once-daily dose given as a 30 min iv infusion, combined with other antibiotics. Infections were bacteriologically proven in 101 patients. The clinical responses showed 83.1% primary success and 83.9% definitive cure predominantly in intensive care patients with hospital-acquired infections and pneumonia. Bacteriological eradication was achieved in 67.3%. Bacteria associated with true failures and colonizations were predominantly Pseudomonas, Acinetobacter and Staphylococcus spp. The risk of nephrotoxicity may be decreased with such a regimen of amikacin, but no conclusions could be drawn with regard to ototoxicity. In summary, a once-daily dosing regimen of amikacin 15 mg/kg is practical and probably efficacious and safe in severely infected patients.
Insights
A once-daily amikacin regimen (15 mg/kg) shows promise for treating severe bacterial infections in hospitalized patients. This dosing strategy appears practical, effective, and safe, potentially reducing nephrotoxicity risks.
Area of Science:
- Infectious Diseases
- Pharmacology
- Critical Care Medicine
Background:
- Severe community and hospital-acquired bacterial infections pose significant treatment challenges.
- Optimizing antibiotic dosing is crucial for efficacy and safety in critically ill patients.
Purpose of the Study:
- To evaluate the efficacy and safety of a once-daily amikacin regimen in patients with severe bacterial infections.
- To assess the clinical and bacteriological outcomes of this dosing strategy.
Main Methods:
- A multicenter, non-randomized, open, prospective study involving 124 hospitalized patients.
- Patients received amikacin (15 mg/kg) once daily via 30-minute IV infusion, combined with other antibiotics.
- Clinical and bacteriological responses were assessed.
Main Results:
- 83.1% primary success and 83.9% definitive cure rates, particularly in intensive care unit patients with hospital-acquired infections and pneumonia.
- Bacteriological eradication achieved in 67.3% of cases.
- Pseudomonas, Acinetobacter, and Staphylococcus spp. were associated with treatment failures.
Conclusions:
- Once-daily amikacin (15 mg/kg) is a practical, likely efficacious, and safe option for severe infections.
- This regimen may reduce the risk of nephrotoxicity, though ototoxicity requires further investigation.