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Amikacin therapy for gram-negative septicemia
Abstract:
Amikacin was administered to 18 patients with gram-negative septicemia. Ten of the patients had blood culture isolates highly resistant to gentamicin; six of these patients had persistent bacteremia while receiving gentamicin alone or in combination with other agents. Fourteen of the 18 patients were cured with amikacin therapy and adjunctive measures. Nine of the 10 patients with gentamicin-resistant pathogens were cured. The occurrence of nephrotoxicity in four patients with elevated amikacin serum levels and serious underlying disease indicates the desirability of monitoring serum amikacin levels. Minor ototoxicity occurred in two patients and was associated with prolonged therapy and high serum amikacin levels. Amikacin is a highly effective agent for treating patients with gram-negative bacteremia; it is the agent of choice in the therapy of patients with suspected or documented gram-negative bacteremia caused by pathogens resistant to gentamicin and susceptible to amikacin.
Insights
Amikacin effectively treated gram-negative septicemia, especially in patients resistant to gentamicin. Monitoring amikacin levels is advised to minimize potential kidney and ear toxicity.
Area of Science:
- Infectious Diseases
- Pharmacology
- Nephrology
Background:
- Gram-negative septicemia poses a significant clinical challenge.
- Gentamicin resistance in gram-negative pathogens complicates treatment options.
Purpose of the Study:
- To evaluate the efficacy and safety of amikacin in patients with gram-negative septicemia.
- To assess amikacin's utility in cases of gentamicin-resistant infections.
Main Methods:
- Amikacin was administered to 18 patients diagnosed with gram-negative septicemia.
- Patient outcomes, including cure rates and adverse events, were monitored.
- Serum amikacin levels were assessed in relation to toxicity.
Main Results:
- Fourteen out of 18 patients achieved cure with amikacin therapy.
- Nine of 10 patients with gentamicin-resistant pathogens were successfully treated.
- Nephrotoxicity and ototoxicity were observed in a subset of patients, associated with elevated serum levels.
Conclusions:
- Amikacin is a highly effective treatment for gram-negative bacteremia.
- It is the preferred agent for infections caused by gentamicin-resistant, amikacin-susceptible gram-negative bacteria.
- Monitoring serum amikacin levels is crucial for optimizing safety and efficacy.