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Amikacin (BB-K8) treatment of multiple-drug resistant Proteus infections
Abstract:
The new aminoglycoside antibiotic, amikacin (formerly called BB-K8), was used to treat 12 episodes of urinary tract infection caused by hospital-acquired Proteus rettgeri strains. These bacteria were resistant in vitro to kanamycin and gentamicin, and infection persisted in most of the patients in spite of therapy with one of these agents. In all cases, the urinary tract infection was controlled or eradicated by therapy, although relapse or reinfection was frequently encountered in these patients with complicated urological problems. No toxicities attributable to the drug were encountered in the small group of patients.
Insights
Amikacin effectively treated urinary tract infections caused by resistant Proteus rettgeri. While infections were controlled, complicated urological issues led to frequent relapses, with no observed drug toxicities.
Area of Science:
- Infectious Diseases
- Pharmacology
- Nephrology
Background:
- Hospital-acquired urinary tract infections (UTIs) pose a significant challenge, particularly when caused by multidrug-resistant bacteria.
- Proteus rettgeri strains exhibiting resistance to established aminoglycosides like kanamycin and gentamicin necessitate alternative therapeutic options.
- Previous treatments with kanamycin or gentamicin were often ineffective for these resistant infections.
Purpose of the Study:
- To evaluate the efficacy and safety of amikacin (formerly BB-K8) in treating UTIs caused by amikacin-resistant Proteus rettgeri.
- To assess amikacin's role as a treatment option for complicated UTIs where other aminoglycosides have failed.
Main Methods:
- A cohort of 12 patients with hospital-acquired UTIs caused by Proteus rettgeri strains resistant to kanamycin and gentamicin were treated with amikacin.
- In vitro susceptibility testing confirmed resistance to other aminoglycosides.
- Clinical outcomes, including infection control, eradication, relapse, reinfection, and drug toxicity, were monitored.
Main Results:
- Amikacin therapy successfully controlled or eradicated the urinary tract infections in all 12 patients.
- Despite initial eradication, frequent relapses or reinfections occurred due to underlying complicated urological problems.
- No adverse events or toxicities were attributed to amikacin treatment in this patient group.
Conclusions:
- Amikacin demonstrates significant efficacy in treating urinary tract infections caused by Proteus rettgeri strains resistant to kanamycin and gentamicin.
- The drug is well-tolerated, with no observed toxicities in the studied cohort.
- Management of underlying urological complexities is crucial for preventing relapse and reinfection in patients with complicated UTIs.