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Amikacin

Amikacin is an aminoglycoside antibiotic used to treat different types of bacterial infections. Amikacin works by binding to the bacterial 30S ribosomal subunit, causing misreading of mRNA and leaving the bacterium unable to synthesize proteins vital to its growth. more...

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Amikacin may be administered once or twice a day but must be given by the intravenous or intramuscular route. There is no oral form available. Dosage must be adjusted in people with kidney failure.

Amikacin is most often used for treating severe, hospital-acquired infections with multidrug resistant Gram negative bacteria such as Pseudomonas aeruginosa, Acinetobacter, and Enterobacter. Amikacin may be combined with a beta-lactam antibiotic for empiric therapy for people with neutropenia and fever.

Side effects of amikacin are similar to other aminoglycosides. Kidney damage and hearing loss are the most important effects. Because of this potential, blood levels of the drug and markers of kidney function (creatinine) may be monitored.

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Nosocomial pneumonia and antibiotic resistance
From CHEST, 10/1/05 by Prashant S. Borade

PURPOSE: The emergence of antibiotic resistant pathogens poses a significant threat to patients with nosocomial pneumonia. It is therefore important to evaluate the relationship between hospital-acquired pathogens and antibiotic resistance.

METHODS: A prospective study was conducted in 100 consecutive patients with hospital-acquired infections admitted to the intensive care unit of which 46% had clinical, laboratory, and radiological evidence of nosocomial pneumonia.

RESULTS: Isolated pathogens consisted of Klebsiella spp. (29%), Pseudomonas spp. (16%), Acinetobacter spp. (13%), Staphylococcus aureus (11%), Escherichia coli (10%), Enterobacter spp. (9%), methicillin-resistant S. aureus (2%), and Candida spp. (9%). Details of antibiotic resistance are shown in Table 1. Mortality was 33% in patients with nosocomial pneumonia.

CONCLUSION: Antibiotic resistance in hospital-acquired pathogens is significant.

CLINICAL IMPLICATIONS: Patients with nosocomial pneumonia remain at risk from antibiotic resistant pathogens.

DISCLOSURE: Prashant Borade, None.

[GRAPHIC OMITTED]

Prashant S. Borade MD * Daniel K. Lee MD Department of Respiratory Medicine, Ipswich Hospital, Ipswich, Suffolk, England, United Kingdom

COPYRIGHT 2005 American College of Chest Physicians
COPYRIGHT 2005 Gale Group

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