[Amikacin in urinary tract infections with so-called problem pathogens]

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.