Amikacin in the treatment of pulmonary tuberculosis

Sensitivity tests on strains from 11 patients with pulmonary tuberculosis, previously treated with kanamycin and/or capreomycin, showed incomplete cross-resistance between amikacin and capreomycin but complete cross-resistance between amikacin and kanamycin. Treatment with amikacin of 4 patients with multiply resistant strains resulted in no response as assessed by sputum smears and cultures, but resistance emerged to amikacin, kanamycin and capreomycin. Amikacin has no role in the treatment of tuberculosis as it cannot be given as an alternative to kanamycin, has no advantages over it and is more expensive.