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[Clinical studies on amikacin for infectious diseases following intravenous drip infusion (author's transl)]
Abstract:
An antibiotic drug of aminoglycoside group, amikacin (AMK) for parenteral use was used to 8 hospitalized patients: 4 with acute or subacute cholecystitis and cholangitis, 4 with acute peritonitis (3 cases were due to acute appendicitis and a case was torsion of right ovarian cyst). AMK in a dose of 200 mg were administered by intravenous drip infusion for 1 to 2 hours, twice a day for 4 to 9 days. To the cases with biliary tract infection, AMK was treated to preoperatively and to the cases with acute peritonitis, AMK was treated to the postoperatively. Clinical response was excellent in 2 cases, good in 6 cases, fair and poor in none. No adverse effect was observed. The organisms were isolated in 4 cases, 4 were Escherichia coli, 1 was Klebsiella pneumoniae and 1 was Bacteroides fragilis. The MIC for AMK were 3.13-1.56 micrograms/ml in 10(8) and 10(6) cells/ml, except Bacteroides fragilis. Before the operation of above cases, AMK in a dose of 200 mg were administered by intravenous drip infusion in 2 cases (acute and subacute cholecystitis and cholangitis with cholelithiasis), 5 cases by intramuscularly and 1 case by intravenously (acute appendicitis with localized peritonitis). The materials of A-bile, B-bile, wall of gallbladder, the appendix, ascites and serum samples were taken during the operation. AMK concentration was measured by bioassay method with Bacillus subtilis ATCC 6633 as test organism. AMK concentration in B-bile were higher than those in the A-bile. AMK concentrations in wall of gallbladder were much higher than those in A and B-bile. The concentrations after intravenous drip infusion were higher than those after intramuscularly administration. AMK changes of inflammation. In a case of gastric ulcer, AMK 200 mg by intravenous drip infusion was administrated, the AMK concentrations of the tissues at 25 minutes after end of infusion, they were 15.00 micrograms/g in gastric ulcer, 7.20 micrograms/g in normal gastric wall, 9.14 micrograms/g in duodenal wall and 8.12 micrograms/g in the omentum, respectively. Serum concentration of AMK on this case at 58 minutes was 15.7 micrograms/ml. Therefore, it was supposed that AMK could be used safety and effective by intravenous drip infusion.
Insights
Amikacin (AMK), an aminoglycoside antibiotic, showed excellent to good clinical response in 8 patients with biliary tract infections and peritonitis. No adverse effects were observed, suggesting AMK is safe and effective for parenteral use.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Medicine
Background:
- Amikacin (AMK), an aminoglycoside antibiotic, was evaluated for parenteral use in hospitalized patients.
- The study focused on patients with biliary tract infections (cholecystitis, cholangitis) and acute peritonitis.
Observation:
- AMK was administered intravenously (IV) at 200 mg twice daily for 4-9 days.
- Preoperative administration was used for biliary tract infections, and postoperative for peritonitis.
- Tissue and serum concentrations of AMK were measured using bioassay, with Bacillus subtilis as the test organism.
Findings:
- Clinical response was excellent in 2 cases and good in 6 cases, with no adverse effects.
- AMK concentrations were higher in gallbladder wall and bile compared to serum.
- Intravenous drip infusion resulted in higher concentrations than intramuscular administration.
- Significant AMK concentrations were found in gastric and duodenal tissues, and omentum following IV infusion.
Implications:
- Amikacin demonstrates safety and efficacy for treating serious infections via parenteral administration.
- Achieving high drug concentrations in infected tissues supports its therapeutic potential.
- Intravenous drip infusion appears to be an effective route for achieving optimal AMK levels.