Gentamicin-resistant bacillary infection. Clinical features and amikacin therapy

Infections caused by gentamicin sulfate-resistant Pseudomonas aeruginosa and Serratia marcescens have occurred in multiple areas of our hospitals and have caused serious clinical illness and death. Isolates of Pseudomonas organisms were sensitive to some alternative drugs including collstin sulfate, but isolates of Serratia organisms were often resistant to all commercially available parenteral antimicrobiais. All isolates were inhibited by amikacin sulfate, and 95% were killed by concentrations achievable in serum with recommended doses. Twenty patients with hospital-acquired infections, including ten with septicemia, were treated with amikacin. Eighteen of the 20 patients had a good clinical and bacteriologic response. Ototoxicity and nephrotoxicity each occurred in one patient.