Amikacin therapy of exacerbations of Pseudomonas aeruginosa infections in patients with cystic fibrosis.

Amikacin, a new semisynthetic aminoglycoside antibiotic with activity against Pseudomonas aeruginosa, was 
used to treat 22 acute exacerbations of chronic pulmonary infections in 
18 patients with cystic fibrosis. Patients ranged from 5 to 32 
years of age and had mucoid P. aeruginosa isolated from sputum. 
The amikacin dose was usually 7.5 mg/kg every eight hours but 
was increased to 10 mg/kg and/or carbenicillin was added in selected 
cases depending on clinical course. Although P. aeruginosa was not eliminated 
from our patients' sputum except in two cases, there was a 
good clinical response in 19 of 22 courses. Significant improvement in 
chest x-ray films, spirometry, or arterial oxygen tension was documented in 
11 of 17 courses. One instance of serum creatinine level elevation 
could not be attributed to this antibiotic. Two patients showed minimal 
(15 dB) unilateral high-frequency hearing loss on serial audiograms. Activity against 
many gentamicin-resistant strains and high blood levels are among the attractive 
properties of amikacin. Amikacin is clinically effective in treating Pseudomonas-associated pulmonary 
infections complicating cystic fibrosis. 