Clinical and bacteriological efficacy, and practical aspects of amikacin given once daily for severe infections.
In a multicentre non-randomized open prospective study, 124 patients hospitalized in medical infectious disease or intensive care units, with severe community and hospital-acquired bacterial infections were treated with 15 mg/kg body weight amikacin in a once-daily dose given as a 30 min iv infusion, combined with other antibiotics. Infections were bacteriologically proven in 101 patients. The clinical responses showed 83.1% primary success and 83.9% definitive cure predominantly in intensive care patients with hospital-acquired infections and pneumonia. Bacteriological eradication was achieved in 67.3%. Bacteria associated with true failures and colonizations were predominantly Pseudomonas, Acinetobacter and Staphylococcus spp. The risk of nephrotoxicity may be decreased with such a regimen of amikacin, but no conclusions could be drawn with regard to ototoxicity. In summary, a once-daily dosing regimen of amikacin 15 mg/kg is practical and probably efficacious and safe in severely infected patients.
Beaucaire
G
G
Intensive Care and Infectious Diseases Unit, University of Lille, Centre Hospitalier Dron, Tourcoing, France.
Leroy
O
O
Beuscart
C
C
Karp
P
P
Chidiac
C
C
Caillaux
M
M
D000328:Adult; D000368:Aged; D000583:Amikacin / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D002439:Cefotaxime / Q000008:administration & dosage; D002442:Ceftazidime / Q000008:administration & dosage; D003428:Cross Infection / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006094:Gram-Positive Bacteria / Q000187:drug effects*; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000008:administration & dosage; D010878:Piperacillin / Q000008:administration & dosage; D011446:Prospective Studies
D015378:Imipenem; D000583:Amikacin; D002442:Ceftazidime; D015242:Ofloxacin; D002439:Cefotaxime; D010878:Piperacillin