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Treatment in Diseases Due to Multiple Resistant Bacilli

Allen R. Sklaver, MD; Richard L. Greenman, MD; Thomas A. Hoffman, MD

Arch Intern Med. 1978;138(5):713-716.

Abstract
The therapeutic efficacy of amikacin was evaluated in patients with serious hospital-acquired infections caused by Gram-negative bacilli susceptible to amikacin, but usually resistant to kanamycin, gentamicin, and tobramycin. The infections for which amikacin was given were Gram-negative bacteremia in 15 patients and Gram-negative meningitis in two patients. Therapy with amikacin resulted in a cure in 13 patients, improvement in 1, and failure in 3. Continuous intravenous infusion of amikacin yielded a high cerebrospinal fluid to serum ratio of amikacin in one case of meningitis and intrathecally administered amikacin yielded high ventricular fluid levels in another case of meningitis. The emergence of resistance to amikacin was noted in one patient treated with amikacin in whom Serratia bacteremia persisted. Treatment with amikacin was usually tolerated well. This study indicates that amikacin is an effective antibiotic in the treatment of serious Gram-negative infections caused by gentamicin-resistant organisms.

(Arch Intern Med 138:713-716, 1978)

Author Affiliations
From the Division of Infectious Diseases, Department of Medicine, University of Miami (Fla) School of Medicine.

Footnotes
Accepted for publication June 7, 1977.

Read in part before the 16th Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Oct 27, 1976.

Reprint requests to Division of Infectious Diseases, University of Miami School of Medicine, PO Box 520875, Biscayne Annex, Miami, FL 33152 (Dr Hoffman).

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