Amikacin monotherapy for sepsis caused by panresistant Pseudomonas aeruginosa.
Two patients with severe sepsis due to panresistant Pseudomonas aeruginosa, deteriorating despite therapy with colistin and β-lactams, were cured with a high daily dose (25 to 50 mg/kg) of amikacin to obtain a peak/MIC ratio of at least 8 to 10 (MIC = 16 μg/ml). Concomitant use of continuous venovenous hemodiafiltration (CVVHDF) provided no deterioration in renal function after treatment. High dosage of aminoglycosides combined with CVVHDF may represent a valuable therapeutic option for infection due to multiresistant pathogens.
Layeux
Brice
B
Department of Infectious Diseases, Erasme University Hospital, Université Libre de Bruxelles, Route de Lennik 808, Brussels, Belgium.
Taccone
Fabio Silvio
FS
Fagnoul
David
D
Vincent
Jean-Louis
JL
Jacobs
Frédérique
F
D000368:Aged; D000583:Amikacin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000472:pathogenicity*; D018805:Sepsis / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology*
D000900:Anti-Bacterial Agents; D000583:Amikacin; D002097:C-Reactive Protein; D003404:Creatinine
Int J Antimicrob Agents. 2007 Jun;29(6):630-6
17306965
Clin Infect Dis. 2007 Sep 15;45(6):753-60
17712761
Pharmacotherapy. 2005 Oct;25(10):1353-64
16185180
Antimicrob Agents Chemother. 1999 Jul;43(7):1549-55
10390201
Lancet Infect Dis. 2004 Aug;4(8):519-27
15288826
Ther Drug Monit. 2008 Dec;30(6):674-81
19057371
Curr Opin Pharmacol. 2009 Oct;9(5):558-65
19748829
Crit Care Med. 2009 Apr;37(4):1463-9
19242341
Crit Care. 2010;14(2):R53
20370907
J Infect Dis. 1987 Jan;155(1):93-9
3540140
Clin Pharmacokinet. 1994 Jun;26(6):457-71
8070219
Clin Microbiol Rev. 2009 Oct;22(4):582-610
19822890
Clin Infect Dis. 2005 Oct 15;41(8):1159-66
16163635