Related Experiment Video

Updated: Aug 10, 2026

Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method
12:03

Antimicrobial Synergy Testing by the Inkjet Printer-assisted Automated Checkerboard Array and the Manual Time-kill Method

Published on: April 18, 2019

Influence of amikacin as the primary aminoglycoside on bacterial isolates in the intensive care unit

J M Hammond1, P D Potgieter, A A Forder

  • 1Department of Medicine, University of Cape Town, South Africa.

Critical Care Medicine
|June 1, 1990
PubMed

Insights

Restricting aminoglycoside use to amikacin in a respiratory ICU increased Gram-negative resistance rates significantly. However, this policy did not impact patient clinical outcomes or alter resistance to other aminoglycosides.

Area of Science:

  • Infectious Diseases
  • Clinical Pharmacy
  • Critical Care Medicine

Background:

  • Rising antimicrobial resistance necessitates strategic antibiotic stewardship.
  • Aminoglycosides are crucial for treating Gram-negative infections, but resistance is a growing concern.

Purpose of the Study:

  • To evaluate the impact of restricting aminoglycoside use to amikacin on Gram-negative resistance patterns.
  • To assess the influence of this policy on clinical outcomes in a respiratory intensive care unit (ICU).

Main Methods:

  • A comparative study analyzing clinical and microbiological data before and after policy implementation.
  • Patient populations were matched for severity of illness (APACHE II scores), age, ventilation status, and invasive procedures.

Main Results:

  • Amikacin resistance increased from 8.5% to 39.6% post-policy.
  • Resistance to tobramycin and netilmicin also rose, despite minimal use of these agents.
  • No significant difference in clinical outcomes was observed between the two periods.

Conclusions:

  • Restricting aminoglycosides to amikacin alone led to increased Gram-negative resistance.
  • The policy did not demonstrate a significant effect on patient outcomes in the respiratory ICU.
  • Antimicrobial stewardship strategies require careful consideration of resistance development and clinical efficacy.

More Related Videos

Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung09:26

Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung

Published on: January 22, 2021

Amikacin Protection Assay for Quantification and Visualization of Escherichia coli Cell Invasion09:22

Amikacin Protection Assay for Quantification and Visualization of Escherichia coli Cell Invasion

Published on: July 3, 2026

Related Concept Videos

Antibiotic Selection00:57

Antibiotic Selection

Overview
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Inhibitors of Bacterial Protein Synthesis01:25

Inhibitors of Bacterial Protein Synthesis

Aminoglycosides constitute a highly potent class of bactericidal antibiotics that exert their antimicrobial effects by targeting the bacterial ribosome, specifically disrupting protein synthesis. These polycationic molecules consist of amino-modified sugars linked via glycosidic bonds to an aminocyclitol core such as 2-deoxystreptamine or streptamine. Their strong positive charges facilitate tight binding to the negatively charged phosphate backbone of ribosomal RNA (rRNA), primarily at the 16S...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...