Amikacin therapy and management of premature infants infected with carbapenem-resistant Klebsiella pneumoniae
10.12092/j.issn.1009-2501.2024.12.010
- VernacularTitle:早产儿感染耐碳青霉烯类肺炎克雷伯菌后的阿米卡星治疗和管理
- Author:
Wenjuan HU
1
;
Qiaoling YANG
;
Xuebin WANG
;
Boyu TAN
;
Yihuan CHEN
;
Huajun SUN
Author Information
1. 上海市儿童医院,上海交通大学医学院附属儿童医院药学部,上海 200040
- Publication Type:Journal Article
- Keywords:
amikacin;
aminoglycosides;
ototoxici-ty;
nephrotoxicity;
prematurity;
carbapenem-resis-tant Klebsiella pneumoniae(CRKP)
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2024;29(12):1401-1408
- CountryChina
- Language:Chinese
-
Abstract:
AIM:To understand the efficacy and safety of amikacin(AMK)for the treatment of car-bapenem-resistant Klebsiella pneumoniae pneu-moniae(CRKP)in preterm infants and to establish a management process for the use of amikacin in preterm infants.METHODS:CRKP-infected preterm infants treated with amikacin between January 2019 and December 2021 were retrospectively ana-lyzed,and parametric data paired t-tests were used to assess the efficacy and safety of amikacin for the included infectious and safety indicators,and to es-tablish a management process for amikacin use in preterm infants.RESULTS:Eight cases of CRKP in-fection were included,with the main diagnosis of pneumonia and sepsis.eight preterm infants were screened for the AMK ototoxicity gene mitochon-drial gene MT-RNR1(MT-RNR1 1494C＞T and MT-RNR11555A＞G)before amikacin treatment,and none of them were found to have the gene variant.after receiving amikacin sulphate injection treat-ment for 7 days,the indicators of infectivity were improved,and was statistically significant(P＜0.01).No clinical ototoxicity or nephrotoxicity was ob-served in the children before or after treatment.CONCLUSION:Aminoglycosides are still the main antibiotics used for the empirical treatment of sus-pected infections in preterm infants,especially drug-resistant bacterial infections.Despite the risk of ototoxicity and nephrotoxicity,we provide man-agement procedures and recommendations for neonatal treatment with amikacin to reduce the risk of ototoxicity and nephrotoxicity in AMK.
