The elimination of gentamicin-resistant gram-negative bacteria in a newborn intensive care unit.
The aminoglycosides play a central role in the treatment of infectious diseases caused by gram-negative bacteria. During the period of January to June 1984, 45 clinical specimens collected in our neonatal intensive care unit grew Enterobacter cloacae; 41 of them were gentamicin resistant. One neonate developed septicemia. The routine antibiotic protocol was then changed from gentamicin-ampicillin to amikacin-ampicillin for a period of six months. During this period the resistance to gentamicin declined to a minimum. Only eight of 122 specimens proved to harbor gram-negative organisms resistant to gentamicin. The gentamicin-resistant E. cloacae vanished. No isolate was resistant to amikacin. The gentamicin-ampicillin regimen was then reintroduced.
D000583:Amikacin / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003428:Cross Infection / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004754:Enterobacter / Q000187:drug effects; D004756:Enterobacteriaceae Infections / Q000188:drug therapy*; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D010403:Penicillin Resistance; D018805:Sepsis / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D005839:Gentamicins; D000667:Ampicillin; D000583:Amikacin