| Abstract | Because of the rapid emergence of resistance to gentamicin and tobramycin among isolates of aerobic and facultative gram-negative bacteria at our university hospital, we designed a prospective study to track aminoglycoside resistance, bacteremic episodes, and bacteremia-associated deaths before and after the institution of amikacin as the sole formulary aminoglycoside. From June 1984 through June 1987 (immediately before this policy change), amikacin accounted for only 20% of patient-days of aminoglycoside therapy, and rates of resistance to gentamicin, tobramycin, and amikacin among aerobic and facultative gram-negative bacterial isolates were 12.8%, 10.8%, and 5.9%, respectively. During the next 30 months (immediately after the change in policy), amikacin accounted for 98% of patient-days of aminoglycoside therapy, and rates of resistance to gentamicin, tobramycin, and amikacin were 6.3%, 5.0%, and 3.3%, respectively. Furthermore, during the latter 30 months, the incidence of both bacteremia and bacteremia-associated death decreased significantly. Hospitals at which resistance to gentamicin or tobramycin is increasing among the gram-negative flora may benefit from the use of amikacin as the principal aminoglycoside. |
| Authors | J W King, M C White, J R Todd, S A Conrad
(Affiliation: Section of Infectious Diseases, Louisiana State University Medical Center, Shreveport 71130.)
|
| Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 14
Issue 4
Pg. 908-15
(Apr 1992)
ISSN: 1058-4838 UNITED STATES |
| PMID | 1576287
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
| Chemical References |
- Gentamicins
- Tobramycin
- Amikacin
|
| Topics |
- Amikacin
(pharmacology, therapeutic use)
- Bacteremia
(drug therapy, epidemiology, microbiology)
- Drug Resistance, Microbial
- Gentamicins
(pharmacology, therapeutic use)
- Gram-Negative Bacteria
(drug effects, isolation & purification)
- Gram-Negative Bacterial Infections
(drug therapy, epidemiology, microbiology)
- Gram-Positive Bacteria
(isolation & purification)
- Gram-Positive Bacterial Infections
(drug therapy, epidemiology, microbiology)
- Humans
- Incidence
- Louisiana
(epidemiology)
- Prospective Studies
- Tobramycin
(pharmacology, therapeutic use)
|
