Based on the proportion of resistant, moderately sensitive, and sensitive strains, the descending order of activity of
amikacin against clinical isolates of urinary pathogens was Salmonella, Klebsiella, Enterobacter, Escherichia coli, Staphylococcus aureus, Citrobacter, Proteus species, and Pseudomonas aeruginosa. However,
amikacin was the most active of the
antibiotics tested (including
gentamicin and
tobramycin) against 100 strains of P. aeruginosa. The calculated half-life of
amikacin was substantially longer in patients with compromised renal function than in normal subjects. Immaturity of renal function, characteristic of the newborn, similarly slowed the rate of excretion of
amikacin. The cure rate (complete clinical remission and eradication of the pathogen) was 91% in 22 patients with
urinary tract infection (including 16 with chronic
pyelonephritis) treated with 500 mg of
amikacin every 8 or 12 hr for eight to 17 days. After single
injections of 7.5 mg/kg 2-3 hr before delivery, appreciable amounts of the
drug were recovered from the cord blood. No local or systemic intolerance or laboratory abnormalities were observed in a total of 42 patients (including eight infants) treated for a maximum of two weeks. No
ototoxicity was demonstrable in any of the 12 patients subjected to audiometry; nystagmography revealed slight vestibular dysfunction in two elderly patients.