title: An evaluation of the susceptibility patterns of gram-negative organisms isolated in cancer centres with aminoglycoside usage.
abstract: This study in 12 cancer treatment centres across the United States was designed to evaluate the potential for increased resistance to amikacin with unrestricted use. An initial 3-month baseline period during which the use of amikacin was restricted and that of tobramycin and gentamicin unrestricted was followed by a period of at least 12 months when amikacin was the primary aminoglycoside. Resistance of Gram-negative bacilli to these aminoglycosides from hospitalized patients was monitored and compared for the two periods. Amikacin usage increased from a mean of 20.1% to a mean of 83.9% of aminoglycoside patient-days. A reduction in the use of tobramycin and gentamicin were observed with means of 66.1 and 10%, and 13.9 and 6.1%, respectively for the two periods. Resistance to amikacin was 0.85% at baseline and 1.3% at end-point which was not clinically significant (P = 0.614). Baseline resistance was 6.5 and 7.6%, while final resistance was 2.6 and 4.8%, respectively for tobramycin (P = 0.001) and gentamicin (P = 0.052).
authors.affiliation: Columbia Regional Hospital, MO 65201.
authors.forename: J J
authors.initials: JJ
authors.lastname: Muscato
authors.forename: D W
authors.initials: DW
authors.lastname: Wilbur
authors.forename: J J
authors.initials: JJ
authors.lastname: Stout
authors.forename: R A
authors.initials: RA
authors.lastname: Fahrlender
mesh_terms: D000150:Acinetobacter / Q000187:drug effects; D000583:Amikacin / Q000008:administration & dosage / Q000494:pharmacology*; D002173:Cancer Care Facilities; D004352:Drug Resistance, Microbial; D004363:Drug Utilization; D004755:Enterobacteriaceae / Q000187:drug effects; D005839:Gentamicins / Q000008:administration & dosage / Q000494:pharmacology*; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006801:Humans; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000187:drug effects; D011815:R Factors; D014031:Tobramycin / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D005839:Gentamicins; D000583:Amikacin; D014031:Tobramycin