1.Amikacin therapy for urinary tract infections caused by extended-spectrum beta-lactamase-producing Escherichia coli.
Sung Yeon CHO ; Su Mi CHOI ; Sun Hee PARK ; Dong Gun LEE ; Jung Hyun CHOI ; Jin Hong YOO
The Korean Journal of Internal Medicine 2016;31(1):156-161
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.
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