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Amikacin therapy for serious gram-negative infection
Abstract:
Amikacin sulfate was administered to 18 patients for the treatment of 19 severe infections. Seventeen infections were caused by gentamicin-resistant Gram-negative bacilli, and 13 patients were bacteremic. Bacteriologic cure was attained in all but one instance, and effective serum, bile, and pleural fluid drug levels were demonstrated. Drug-related fever occurred in one patient, and another experienced a maculopapular rash and monilial intertrigo. In three patients, reversible renal toxicity developed, but none had clinical evidence of ototoxicity. Amikacin sulfate in a dose of 15 mg/kg/day is an effective antibiotic for the treatment of serious Gram-negative infections, particularly those due to gentamicin-resistant organisms.
Insights
Amikacin sulfate effectively treated severe Gram-negative infections, including those resistant to gentamicin. This antibiotic demonstrated high cure rates with manageable side effects in patients with serious bacterial infections.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Severe Gram-negative bacterial infections pose significant treatment challenges, especially when resistant to conventional antibiotics.
- Gentamicin resistance in Gram-negative bacilli necessitates alternative therapeutic options.
- Amikacin sulfate is an aminoglycoside antibiotic with broad-spectrum activity.
Purpose of the Study:
- To evaluate the efficacy and safety of amikacin sulfate in treating severe Gram-negative infections.
- To assess drug levels in various body fluids.
- To identify adverse effects associated with amikacin sulfate treatment.
Main Methods:
- A prospective study involving 18 patients with 19 severe infections.
- Amikacin sulfate administered at a dose of 15 mg/kg/day.
- Monitoring of bacteriologic cure, serum, bile, and pleural fluid drug levels, and adverse events.
Main Results:
- Bacteriologic cure was achieved in 18 out of 19 infections (94.7%).
- Effective drug concentrations were demonstrated in serum, bile, and pleural fluid.
- Adverse events included drug-related fever (1 patient), rash with monilial intertrigo (1 patient), and reversible renal toxicity (3 patients). No ototoxicity was observed.
Conclusions:
- Amikacin sulfate is an effective antibiotic for treating severe Gram-negative infections, particularly those caused by gentamicin-resistant organisms.
- The drug is well-tolerated, with manageable and reversible side effects.
- Therapeutic drug monitoring confirmed adequate drug levels in key body fluids.