EMERGENCE OF RESISTANCE TO AMIKACIN DURING TREATMENT OF BURN WOUNDS - ROLE OF ANTIMICROBIAL SUSCEPTIBILITY TESTING

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  • 1 January 1976
    • journal article
    • research article
    • Vol. 79  (2) , 224-228
Abstract
Amikacin has been used to treat Providencia stuartii infections on the Burn Service at Los Angeles County/University of Southern California Medical Center (USA) since March, 1973. The median minimal inhibitory concentration (MIC) of strains collected on this service prior to the introduction of amikacin was 3.13 .mu.g/ml, while the median MIC of strains collected during the last 4 mo. of the study was 12.5 .mu.g/ml. High bactericidal concentrations (MBC) noted at the time of initial studies predicted the emergence of resistant clones, with MBC values rising to 100 .mu.g/ml. Isolates from burn patients during the initial 5 days of treatment with amikacin had a median MIC of 6.25 .mu.g/ml, in contrast to values of 25 .mu.g/ml in strains isolated after 5 days of treatment. The epidemiologic significance of intensive treatment of gram-negative infections occurring in a closed population with selected antibiotics is discussed. The performance of susceptibility tests which included determination of bactericidal concentrations was a major tool in the recognition of the potential for selection of resistant microorganisms.

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