Amikacin once every other day versus Daily Meropenem for Treatment of Urinary Tract Infection with Escherichia Coli

Abstract

Background and Aim: Urinary tract infection (UTI) is a common medical challenge, especially in the light of increased antibiotic resistance. This work aimed to compare between amikacin (3 doses, once each other day) with a daily dose of meropenem (once daily for seven days) for the treatment of urinary tract infection caused by Escherichia Coli. 
 Patients and Methods: 70 patients with confirmed UTI infection by E. Coli were included and divided for two groups. The first was treated by amikacin 15mg/kg once every 48 hours for seven days. The second group was treated by meropenem 1 g three times daily for one week. Then, urinary culture and sensitivity was re-performed and tested against the commonest panel of antibiotics. The clinical manifestations were documented before treatment and one week after treatment.
 Results: There was no significant difference between groups regarding patient demographics or manifestations of UTI. 54.3% in amikacin and 65.7% in meropenem groups reported previous UTI. The clinical manifestations of UTI include dysuria, frequent urination, flank pain, abdominal pain, fever and suprapubic pain. The treatment was associated with eradication of E. Coli in 60.0% and 54.3% in Amikacin and meropenem respectively, with no significant differences between groups at the end of the first week and at that time, the most sensitive drugs were nitrofurantoin (34.3%) followed by meropenem (22.9%) and amikacin (18.6%). However, the highest resistance was registered for cefepime and cefotaxime (41.4%) followed by ceftazidime-clavulanic acid (40.0%). Clinical manifestations of UTI were significantly reduced in both groups one week after treatment with no significant differences between groups.
 Conclusion: Amikacin could be considered as is an effective and safe alternative to meropenem for treatment of UTI due to E. Coli.