Amikacin Therapy of Serious Gram-Negative Bacillary Infections in Chronic Hemodialysis Patients

Meyer, Richard D.; Lewis, Robert P.; Finegold, Sydney M.

doi:10.1159/000237778

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…There are controversial findings about the resistant pattern of bacteria causing septicemia. A study conducted on bacterial isolate indicates that 55.56% of gram-negative bacteria were resistant to amikacin [ 19 ]. In such condition, it is recommended that aminoglycoside could be given in high dose.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Sepsis Pathogens and Resistance Patterns in a South Asian Tertiary Care Hospital

Rehman

Shah

Afridi

et al. 2021

Cureus

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The aim of this study was to determine common microorganisms causing septicemia and their antimicrobial sensitivities in patients admitted to a tertiary care hospital. MethodsA cross-sectional study was conducted using clinical criteria to diagnose patients as having septicemia where blood for culture and sensitivity (CS) was sent to the laboratory of a tertiary care hospital, Rehman Medical Institute, (Peshawar), Pakistan, during 2019. All patients diagnosed with septicemia regardless of age and gender were included in the study. The blood CS report was collected after 7-14 days of inoculation. Data were recorded on structured performa and analyzed using SPSS Version 20 (IBM Corp.). ResultsA total of 176 patients, with a mean age of 2.92±1.32 years, fulfilled the criteria for sepsis with a mean age of 2.92±1.32 years. Among them, 61.9% were male and 38.1% were female. Among common bacterial isolates, Staphylococcus aureus was found in 37.5% of samples followed by skin contaminants (18.2%), methicillinresistant Staphylococcus aureus (MRSA) (14.8%), and Escherichia coli in (11.4% cases). None of the antibiotics had susceptibility of more than 60%. Susceptibility to piperacillin/tazobactam and ampicillin/sulbactam was found in 21.5% and 14.6% of the samples, respectively, while in cephalosporins, cefoxitin's susceptibility was 28.5%, whereas both ceftriaxone and cephazolin were equally effective in 19.4% cases. Furthermore, 38.9% of the samples were susceptible to ciprofloxacin and 24.3% to levofloxacin. The susceptibilities of amikacin and gentamicin in aminoglycosides were 56.3% and 47.2%, respectively, while that of imipenem and meropenem were 59.7% and 22.9%, respectively. Lastly, clindamycin had an efficacy in 42.4% of samples. ConclusionThe susceptibility of bacterial isolates in septicemia to common antibiotics was low, thus risking therapeutic failure in septic patients. Widespread resistance may be due to the excessive use along with over-thecounter availability of antibiotics, which therefore requires regulation as it is an alarming situation.

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Section: Discussionmentioning

confidence: 99%

Bacterial Sepsis Pathogens and Resistance Patterns in a South Asian Tertiary Care Hospital

Rehman

Shah

Afridi

et al. 2021

Cureus

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Accidental amikacin overdose in man: Emergency therapy by extrarenal dialysis

et al. 1979

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Post-Dialysis Parenteral Antimicrobial Therapy in Patients Receiving Intermittent High-Flux Hemodialysis

Cimino

Burnett

Vyas

et al. 2021

Drugs

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Patients with end-stage renal disease (ESRD) requiring intermittent hemodialysis (IHD) are at increased risk of infection, which represents a leading cause of mortality in this population. The use of additional vascular access devices such as peripherally inserted central catheters to treat such infections should be minimized in patients with ESRD requiring IHD in order to mitigate complications such as infection and thrombosis and to maintain venous patency for hemodialysis access. Intravenous antimicrobial dosing following IHD has the advantages of avoiding additional access devices and providing convenience for patients and providers. Vancomycin, cefazolin, and aminoglycosides have historically been regarded as the primary intravenous antimicrobials administered with IHD given their relatively low cost, convenient dosing, and longevity of clinical use. Despite this, a growing body of literature is evaluating the use of an expanded list of antimicrobials that may be employed using post-dialysis dosing for patients requiring IHD; however, the available data are largely limited to pharmacokinetic studies and small cohorts of infected patients or uninfected subjects. Post-dialytic dosing of intravenous antimicrobials may be considered on a patient-by-patient basis after careful consideration of clinical, microbiological, and logistical factors that may influence the probability of treatment success. This document reviews and evaluates currently available information on the post-dialytic administration of an expanded list of intravenous antimicrobials in the setting of thrice-weekly, high-flux IHD.

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Amikacin Therapy of Serious Gram-Negative Bacillary Infections in Chronic Hemodialysis Patients

Cited by 4 publications

References 17 publications

Bacterial Sepsis Pathogens and Resistance Patterns in a South Asian Tertiary Care Hospital

Bacterial Sepsis Pathogens and Resistance Patterns in a South Asian Tertiary Care Hospital

Accidental amikacin overdose in man: Emergency therapy by extrarenal dialysis

Post-Dialysis Parenteral Antimicrobial Therapy in Patients Receiving Intermittent High-Flux Hemodialysis

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