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Role of Aminoglycosides in Face of Introduction of New Beta-Lactam Antibiotics in Treatment of Nosocomial Infection

Published online by Cambridge University Press:  02 January 2015

John E. McGowan Jr. ,
David B. McClellan  and
Paula S. Irwin
John E. McGowan Jr.*
Affiliation:
Departments of Pathology and Laboratory Medicine and Medicine (Infectious Diseases), Emory University School of Medicine and the Clinical Microbiology Laboratory, Grady Memorial Hospital, Atlanta, Georgia
David B. McClellan
Affiliation:
Departments of Pathology and Laboratory Medicine and Medicine (Infectious Diseases), Emory University School of Medicine and the Clinical Microbiology Laboratory, Grady Memorial Hospital, Atlanta, Georgia
Paula S. Irwin
Affiliation:
Departments of Pathology and Laboratory Medicine and Medicine (Infectious Diseases), Emory University School of Medicine and the Clinical Microbiology Laboratory, Grady Memorial Hospital, Atlanta, Georgia
*
Clinical Microbiology (Box 248), Grady Memorial Hospital, 80 Butler Street, Atlanta, GA30335
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Abstract

Aminoglycosides often are employed for empiric therapy of nosocomial infection because of their activity against a wide spectrum of gram-negative aerobic bacilli (GNAB). New beta-lactam antimicrobials also are active against many GNAB. As toxicity appears less likely for the beta-lactams than for aminoglycosides, their use might be preferable if susceptibility profiles were equivalent.

We studied susceptibility of 90 GNAB recovered from blood culture during a three-month period. All were susceptible to aminoglycosides; 93% were susceptible to at least one of the following: ampicillin, carbenicillin, ticarcillin, cephalothin, chloramphenicol or trimethoprim-sulfamethoxazole. All were susceptible to at least one of our newer beta-lactams (cefamandole, cefoxitin, cefotaxime, moxalactam, piperacillin), but the percentage susceptible to any single beta-lactam was lower than that for any of the aminoglycosides tested. All of the isolates were susceptible to combinations of two beta-lactam drugs.

In our hospital, beta-lactams may be reasonable alternatives to aminoglycosides in selected cases where susceptibility has been demonstrated. However, aminoglycosides continue to provide the broadest single-drug coverage for empiric therapy of known or suspected sepsis with GNAB. The utility of combinations of beta-lactam drugs for empiric therapy requires further assessment by clinical trials.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 4 , Issue 6 , December 1983 , pp. 440 - 443
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1983

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