Clinical Evaluation of Amikacin in Treatment of Infections Due to Gram-Negative Aerobic Bacilli

Abstract

The efficacy and safety of amikacin were evaluated in 42 patients with infections presumed to be due to gram-negative rods. The dosage of 7.5 mg of amikacin/kg every 12 hr was administered intramuscularly to 32 patients and intravenously to seven patients; three patients with renal impairment were given a modified regimen. The duration of treatment was three to 51 days (mean, 9.6 days). Of 19 patients with acute pyelonephritis, five had positive blood culture results. Ten patients had chronic urinary infection, and isolates of Pseudomonas aeruginosa from four of these patients acquired resistance to amikacin during therapy. Of seven patients with gram-negative bacteremia from sources other than the urinary tract, four showed satisfactory and three had less than optimal responses to therapy with amikacin. Two patients with chronic osteomyelitis or soft tissue infection improved but subsequently relapsed. Two patients with acute febrile illness, in whom the etiologic agent was unidentified, recovered. Serial audiograms revealed no change in 26 of 27 patients; one had a significant deterioration in hearing. A transient rise in the level of serum creatinine was noted in three patients. Serial tests of liver function revealed no abnormalities.

Comparison of Netilmicin and Amikacin in Treatment of Complicated Urinary Tract Infections

“…Amikacin, another recently developed semisynthetic aminoglycoside, has proven effective in treatment of various infections, and its toxicity seems to be similar to that of gentamicin (3,6,10 12 h for 7 to 10 days. All patients had complicated urinary tract infections, mainly due to obstruction of the lower urinary tract from benign hyperplasia, prostate or bladder carcinoma, or urethral stricture.…”