Empiric Use of Aminoglycosides in Hospitals

Excerpt

To the editor: Amikacin, a semisynthetic derivative of kanamycin A, was approved for unrestricted clinical use in 1976 and is considered the antibiotic of choice for use against infections with gentamicin-resistant, gram-negative bacilli (1, 2). In a recent issue, Betts and colleagues (3) have reported data on the use of amikacin as the primary empiric aminoglycoside in a large university hospital. The authors have concluded that "because it is not possible to identify patients infected with gentamicin-resistant organisms until 48 hours after therapy is initiated, it is rational to use an antibiotic agent that is likely to be effective against