The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Amikacin therapy for urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli

  • Cho, Sung-Yeon (Division of Infectious Diseases, Department of Internal Medicine, and Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea) ;
  • Choi, Su-Mi (Division of Infectious Diseases, Department of Internal Medicine, and Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea) ;
  • Park, Sun Hee (Division of Infectious Diseases, Department of Internal Medicine, and Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea) ;
  • Lee, Dong-Gun (Division of Infectious Diseases, Department of Internal Medicine, and Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea) ;
  • Choi, Jung-Hyun (Division of Infectious Diseases, Department of Internal Medicine, and Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea) ;
  • Yoo, Jin-Hong (Division of Infectious Diseases, Department of Internal Medicine, and Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea)
  • Received : 2014.11.09
  • Accepted : 2015.03.02
  • Published : 2016.01.01
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Abstract

Background/Aims: The number of urinary tract infections (UTIs) caused by extended-spectrum ${\beta}$-lactamase-producing Escherichia coli (ESBL-EC) is increasing. In an outpatient setting, there are limited therapeutic options to treat ESBL-producing pathogens. We evaluated the outcomes of amikacin outpatient parenteral antibiotic therapy (OPAT) for UTIs caused by ESBL-EC in patients not pre-treated with carbapenem. Methods: We retrospectively evaluated the outcomes of amikacin OPAT for UTIs caused by ESBL-EC. Results: From November 2011 to October 2012, eight females, who could not be hospitalized for carbapenem treatment, were treated with amikacin OPAT for nine episodes of non-bacteremic ESBL-EC UTIs. Seven of the eight patients had one or more comorbidities. Of the nine UTI cases, three had symptomatic lower UTIs and six had non-bacteremic upper UTIs. In all of the cases, symptomatic and laboratory improvements were observed following amikacin OPAT. One patient showed a delayed relapse with bilateral microabscesses 3 weeks after treatment cessation; however, a clinical and microbiological cure was eventually reached. All of the patients were able to tolerate amikacin OPAT without any significant nephrotoxicity or ototoxicity. Conclusions: Amikacin OPAT represents a feasible therapeutic option for non-bacteremic UTIs caused by ESBL-EC in settings with limited resources.

Keywords

References

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