The inhaled antibiotic, Amikacin
Inhale, was being assessed for its effect on survival in patients with Gram-negative pneumonia.
Among the non-[beta]-lactam agents, amikacin
Culture grew Mycobacterium abscessus which was sensitive to amikacin
, linezolid and clarithromycin.
Pseudomonas Aeruginosa (n= 2): - Nalidixic acid (100%), Nitrofurantoin (100%) > Cotrimoxazole (50%), Norfloxacin (50%) and all were susceptible to Cefuroxime, Gentamicin and Amikacin
Background: Aerosolized amikacin
(AA) is a current option for the management of ventilator-associated pneumonia (VAP) caused by multidrug-resistant Gram-negative bacteria (MDR-GNB), as it is reported that AA could increase the alveolar level of the drug without increasing systemic toxicity.
Antimicrobial discs used for sensitivity testing by disc diffusion method were Imepenem 10mcg, piperacillin/ tazobactam 100/10 mcg, Ceftazidime 30mcg Cefotaxime 30mcg, Amikacin
30mcg, Gentamicin 10mcg, Levofloxacin 5mcg, Ceftroaxone 30 mcg, Cefoxitin 30mcg, Amoxycillin/ Clavulanic acid 20/10mcg.
For Gram-positive organisms ampicillin, cefoxitin, cefixime, azithromycin, ofloxacin, amikacin
, clindamycin, amoxicillin + clavulanic acid, vancomycin, and linezolid were used.
The antibiotics tested for sensitivity were Gentamicin (30ug), Amikacin
(30ug), Imipenem (10ug), Tazobactam (110ug), Septran (25ug), Fosfomycin (50ug), Nitrofurantoin (300ug), Tobramycin (30ug), Amoxacillin/clavulinic acid 2:1(30ug), Cefixime (30ug), Cefuroxime (30ug), Cefradine(30ug), Cefoperazone(75ug), Ceftriaxone (30ug), Cefotaxime (30ug), Ceftazidime (30ug), Ciprofloxacin (5ug), Ofloxacin (5ug), Levofloxacin (5ug) and Moxifloxacin (5ug).
After intravenous catheterization of the medial metatarsal vein and placing a tourniquet at the femoral-tibiotarsal joint of the right leg, regional limb perfusion with amikacin
and flunixin meglumine was performed.
On the 12th day, meropenem was switched to Colistin (450 mg/day, iv) and amikacin
(15 mg/kg/day, iv, for 10 days) due to hospital-acquired pneumonia with the result of deep tracheal aspiration culture positivity for carbapenem resistant, colistin and amikacin
sensitive Acinetobacter baumannii plus Pseudomonas aeruginosa.
Antimicrobial discs of piperacillin/tazobactam (TZP; 100/10 ug/ml), amikacin
(AK; 30 ug/ml), ciprofloxacin (CIP; 5 ug/ml), ceftazidime (CAZ; 30 ug/ml), meropenem (MEM; 10 ug/ml) and aztreonam (ATM; 30 ug/ml) were obtained from Oxoid.
Pseudomonas aeruginasa was highly sensitive to Ciprofloxacin, Amikacin