Amikacin urinary tract

In a leading cancer center in Houston, 24% of 758 Gram negative clinical isolates were resistant to tobramycin and 12% were resistant to amikacin (138). In 3144 bacterial isolates causing urinary tract infections in Chile, 74% were identified as Escherichia colv, 4.2% of these strains were resistant to gentamicin, and 1.3% were resistant to amikacin (139). In contrast, the resistance levels were 30% and 17% respectively, in the other enterobacterial strains. In Brazil, all isolates of methicillin-resistant S. aureus were also resistant to gentamicin, amikacin, kanamycin, neomycin, and tobramycin (140), and 97% of such strains from Spain were resistant to tobramycin (141). 

A 39-year-old man with suspected urinary tract infection received amikacin and after 4 days he developed severe renal tubular dysfunction resulting in refractory hypokalemia, hypocalcemia, hypomagnesemia, metabolic alkalosis, and polyuria. This constellation of biochemical abnormalities mimic Type 5 Bart-ter s syndrome (activating mutation of the calcium sensing receptor in the thick ascending loop of Henle and the distal tubule). Laboratory values returned to normal 15 days after discontinuation of amikacin... 

Urinary tract The prevalence of gentamicin- and amikacin-induced nephrotoxicity has been studied in patients with normal baseline renal function eight of 49 patients receiving amikacin developed nephrotoxicity [8 ]. Amikacin-induced nephrotoxicity did not significantly depend on dosing frequency (see also Gentamicin ). 

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