Amikacin therapy for urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli.
10.3904/kjim.2016.31.1.156
- Author:
Sung Yeon CHO
1
;
Su Mi CHOI
;
Sun Hee PARK
;
Dong Gun LEE
;
Jung Hyun CHOI
;
Jin Hong YOO
Author Information
1. Division of Infectious Diseases, Department of Internal Medicine, and Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. sumichoi@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Amikacin;
Beta-lactamases;
Outpatients;
Urinary tract infections
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Ambulatory Care;
Amikacin/administration & dosage/adverse effects/*therapeutic use;
Drug Administration Schedule;
Escherichia coli/*drug effects/enzymology/isolation & purification;
Escherichia coli Infections/diagnosis/*drug therapy/microbiology/urine;
Humans;
Microbial Sensitivity Tests;
Middle Aged;
Recurrence;
Remission Induction;
Retrospective Studies;
Time Factors;
Treatment Outcome;
Urinalysis;
Urinary Tract Infections/diagnosis/*drug therapy/microbiology/urine;
Urine/microbiology;
beta-Lactamase Inhibitors/administration & dosage/adverse effects/*therapeutic use;
beta-Lactamases/*metabolism
- From:The Korean Journal of Internal Medicine
2016;31(1):156-161
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The number of urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) is increasing. In an outpatient setting, there are limited therapeutic options to treat ESBL-producing pathogens. We evaluated the outcomes of amikacin outpatient parenteral antibiotic therapy (OPAT) for UTIs caused by ESBL-EC in patients not pre-treated with carbapenem. METHODS: We retrospectively evaluated the outcomes of amikacin OPAT for UTIs caused by ESBL-EC. RESULTS: From November 2011 to October 2012, eight females, who could not be hospitalized for carbapenem treatment, were treated with amikacin OPAT for nine episodes of non-bacteremic ESBL-EC UTIs. Seven of the eight patients had one or more comorbidities. Of the nine UTI cases, three had symptomatic lower UTIs and six had non-bacteremic upper UTIs. In all of the cases, symptomatic and laboratory improvements were observed following amikacin OPAT. One patient showed a delayed relapse with bilateral microabscesses 3 weeks after treatment cessation; however, a clinical and microbiological cure was eventually reached. All of the patients were able to tolerate amikacin OPAT without any significant nephrotoxicity or ototoxicity. CONCLUSIONS: Amikacin OPAT represents a feasible therapeutic option for non-bacteremic UTIs caused by ESBL-EC in settings with limited resources.
