Amikacin in the treatment of gram-negative pneumonia.

A clinical efficacy study of amikacin in the treatment of 15 adults with nonbacteremic, gram-negative bacillary pneumonia is presented. All patients had serious underlying illnesses (11 organic heart disease, five chronic obstructive pulmonary disease, one cancer); 11 had undergone major surgical procedures. All had required respiratory assistance during their hospitalization and all had recently received other antibiotics. Thirteen of 15 patients showed clinical improvement with amikacin therapy; the pathogen was also eradicated in 10 of the 13. The mean minimum inhibitory concentration of amikacin for the 17 isolated pathogens was 3.13 microng/ml. The mean peak serum concentration of amikacin was 17.7 microng/ml. No evidence of ototoxicity or nephrotoxicity was seen. Seventy-three case reports submitted to the manufacturer by multiple investigators of patients with gram-negative pneumonia, treated with amikacin, are also reviewed. All isolated pathogens were sensitive to both amikacin and gentamicin. Fifty-four (74%) of these patients showed improvement with amikacin therapy.