Amikacin: in vitro bacteriological studies, levels in human serum, lung and heart tissue, and clinical results.

Abstract

The amikacin sensitivity of bacteria cultured from 3282 clinical cases of mixed type was determined. Gentamicin and amikacin were equally effective against E. coli strains. Amikacin inhibited the growth of more Pseudomonas aeruginosa strains than did gentamicin. Against Gram-positive bacteria gentamicin proved to be more effective. Many of the gentamicin-resistant strains were sensitive to amikacin. Amikacin levels were measured during 21 pulmonary and 14 heart operations, subsequent to a intramuscular administration of 500 mg amikacin. The serum contained 17-20 microgram/ml amikacin, in the intact, inflamed and tumourous parts of removed lung tissue 9, 6 and 6 microgram/g concentrations were detected, respectively, whereas the cardiac auricle and the pericardial fluid contained 3-4 and 2-4 microgram/ml, respectively. These amikacin levels reach or in most cases even exceed the minimal inhibiting concentrations against the bacteria. Therefore, amikacin is excellent for the treatment of respiratory infections, pericarditis and endocarditis caused by Gram-negative, gentamicin-resistant bacteria. Amikacin treatment of 8 patients with grave diseases as well as the successful local administration of amikacin based on the therapy of 55 cases of surgical suppurations is reported.