title: Replacement of gentamicin by amikacin as a means of decreasing gentamicin resistance of gram-negative rods in a neonatal intensive care unit.
abstract: The emergence of resistance in bacteria that colonize infants in a neonatal intensive care unit (NICU) is of great concern and a serious therapeutic problem. During the years 1980 to 1981, continuous surveillance of bacterial colonization was carried out on 499 infants admitted to the NICU of the Beilinson Medical Center. Antibiotic sensitivity testing was performed on all organisms isolated. At the end of 1980 and the beginning of 1981, an increased number of gram-negative rods became gentamicin-resistant. It was assumed that the discontinuation of gentamicin usage and replacement with another aminoglycoside, amikacin, would bring about a reduction in gentamicin resistance. Replacement of gentamicin by amikacin resulted in a significant decrease in gentamicin-resistant Escherichia coli and Klebsiella within 3 to 6 months. The emergence of resistant strains can be detected by surveillance methods and overcome by a change in the antibiotic regimen.
mesh_terms: D000583:Amikacin / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D003428:Cross Infection / Q000188:drug therapy*; D004352:Drug Resistance, Microbial; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D007363:Intensive Care Units, Neonatal; D007612:Kanamycin / Q000031:analogs & derivatives*
chemical_list: D005839:Gentamicins; D007612:Kanamycin; D000583:Amikacin