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[Amikacin in urinary tract infections with so-called problem pathogens]
Abstract:
Amikacin (Biklin) was applied in 33 patients with and without renal insufficiency, suffering of non-obstructive inflammations of the urinary tract, caused by multiple resistant hospital germs. The dosage was 125.0--1000.0 mg/die, injected as short infusion and solved in dextrose 5%. The serum and urine concentrations were measured simultaneously. In 18 cases an infection could not be seen after a control period of 8 days up to 4 weeks. Persistence of bacteria happened in five cases. Reinfection could be noted in 5 other cases. Side effects--as oto- or nephrotoxicity, pathological changes of the differential blood count, increasing of the serum transaminases and phosphatases--were seen neither during nor after the therapy.
Insights
Amikacin effectively treated urinary tract infections caused by resistant bacteria in 33 patients. No significant side effects were observed, indicating a favorable safety profile for this antibiotic.
Area of Science:
- Pharmacology
- Infectious Diseases
- Nephrology
Background:
- Urinary tract infections (UTIs) are common, often caused by multidrug-resistant hospital-acquired bacteria.
- Amikacin is an aminoglycoside antibiotic with broad-spectrum activity, but its use in patients with renal insufficiency requires careful monitoring.
Purpose of the Study:
- To evaluate the efficacy and safety of amikacin in treating non-obstructive UTIs caused by multidrug-resistant bacteria.
- To assess amikacin's pharmacokinetic profile, including serum and urine concentrations, in patients with and without renal insufficiency.
Main Methods:
- A prospective study involving 33 patients with UTIs caused by resistant Gram-negative bacteria.
- Amikacin was administered at dosages ranging from 125.0 to 1000.0 mg/day via short infusion in 5% dextrose.
- Serum and urine concentrations of amikacin were measured concurrently.
Main Results:
- Amikacin therapy resulted in the eradication of infection in 18 out of 33 patients after a follow-up period of 8 days to 4 weeks.
- Bacterial persistence was observed in 5 cases, and reinfection occurred in another 5 cases.
- No significant adverse effects, including ototoxicity, nephrotoxicity, hematological changes, or elevated liver enzymes, were reported during or after treatment.
Conclusions:
- Amikacin demonstrates significant efficacy in treating UTIs caused by multidrug-resistant hospital-acquired pathogens.
- The antibiotic exhibits a favorable safety profile, with a low incidence of adverse events even in patients with compromised renal function.
- Amikacin is a viable therapeutic option for complicated UTIs when causative agents are resistant to other antibiotics.