Overview of first-line amikacin therapy for urologic infections.

Severe infections in urologic patients are frequently and effectively treated with aminoglycoside medications. Because of the frequency of nosocomial gram-negative infections in urologic patients, antimicrobial therapy with broad-spectrum antibiotics, such as aminoglycosides, is an integral part of management of urinary infections. Amikacin, because of its activity against infections caused by Pseudomonas, Serratia, and other frequently resistant bacteria, as well as its ability to achieve high blood and tissue levels, provides a significant advantage over other aminoglycoside agents in hospitalized urologic patients with suspected nosocomial infections. Although amikacin remains the most expensive of the aminoglycoside agents, its use is prudent in infections in which the causative organism is suspected but not definitively identified and when treatment must be started before specific culture and sensitivity information is available. In these situations, the most potent antibiotic agent with the broadest spectrum for eliminating infections caused by suspect organisms must be chosen, and amikacin is an ideal choice.