Amikacin for the treatment of carbapenem-resistant Klebsiella pneumoniae infections: clinical efficacy and toxicity
| Autor: | Maria Helena Rigatto, Douglas Mathos, Giulia Soska Baldissera, Alexandre P. Zavascki, Aline Sartori, Diógenes Rodrigues |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Clinical Microbiology - Research Paper Combination therapy medicine.drug_class Antibiotics Microbial Sensitivity Tests Microbiology Nephrotoxicity Young Adult 03 medical and health sciences Internal medicine Media Technology medicine Humans Amikacin Aged Retrospective Studies 030304 developmental biology Aged 80 and over 0303 health sciences Colistin 030306 microbiology business.industry Acute kidney injury Retrospective cohort study Acute Kidney Injury Middle Aged medicine.disease Anti-Bacterial Agents Klebsiella Infections Klebsiella pneumoniae Carbapenem-Resistant Enterobacteriaceae Treatment Outcome Carbapenems Female business Polymyxin B medicine.drug |
| Zdroj: | Braz J Microbiol |
| ISSN: | 1678-4405 1517-8382 |
| DOI: | 10.1007/s42770-021-00551-x |
| Popis: | Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) are an increasing global threat with limited therapeutic options. Our objective was to evaluate clinical and microbiological outcomes of patients treated with amikacin for CRKp infections. We did a retrospective cohort of patients > 18 years old, with CRKp infections treated with amikacin in two tertiary care hospitals in Porto Alegre, Brazil. The impact of clinical factors, antibiotic treatment, and amikacin minimum inhibitory concentration (MIC) on patients’ 30-day mortality was assessed. Microbiological clearance and nephrotoxicity (assessed by RIFLE score) were evaluated as secondary outcomes. A Cox regression analysis was done for mortality. We included 84 patients for analysis. Twenty-nine (34.5%) patients died in 30 days. Amikacin MIC values ranged from 0.125 to 8 μg/mL and did not influence on mortality, regardless of the prescribed dose of this antibiotic (P = 0.24). Bacterial clearance occurred in 17 (58.6%) of 29 patients who collected subsequent cultures. Two (16.6%) of the 12 persistently positive cultures changed the amikacin susceptibility profile from susceptible to intermediate. Twenty-nine (37.2%) patients developed acute kidney injury (AKI): risk 13, injury 11, and failure 5. Risk factors for AKI were higher baseline eGFR (P |
| Databáze: | OpenAIRE |
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