Long-term amikacin use. Effects on aminoglycoside susceptibility patterns of gram-negative bacilli

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Abstract
Amikacin sulfate was first used sparingly at a cancer center in 1976; since 1979, it has been the only aminoglycoside used for systemic cancer therapy for patients with granulocytopenia. As the development of resistance has been correlated with antibiotic use over time, one wished to determine if prolonged use of amikacin in the patients led to increased amikacin resistance. A total of 1129 strains were recovered from 315 patients during a 13-mo. period. Each species isolated per patient was considered once. Of the patients, 7% had amikacin-resistant strains (2.7% of isolates), and 10% of the patients had gentamicin-resistant strains (4% of isolates). Amikacin resistance was significantly less than in an earlier study. Unrestricted use of amikacin has not led to a concomitant increase in amikacin resistance to gram-negative bacilli.