Gentamicin in Gram-Negative Urinary and Pulmonary Infections

Abstract

The incidence of life-threatening Gramnegative bacterial infections has increased strikingly during recent years.^1,2The majority of these arise within the hospital environment and often resist treatment with ordinarily effective antibiotics including the tetracyclines, streptomycin, and chloramphenicol. The broad-spectrum, semisynthetic penicillins (ampicillin [Penbritin]) have not been effective against most severe hospital-acquired Gram-negative microorganisms.³Kanamycin has been useful, but increasing numbers of microorganisms are now resistant to it⁴and it has considerable toxicity. Colistin is less hazardous and is especially valuable in<i>Pseudomonas</i>infections,⁵but it is not satisfactory as a broad-spectrum antibiotic for hospital-acquired Gram-negative infections. Recently, we have studied a new antibiotic, gentamicin.* It is a fermentation product of<i>Micromonospora purpura</i>, a member of the family Streptomycetaceae.⁶In vitro studies by Weinstein et al⁶have indicated considerable activity against most Gram-negative organisms, including those resistant to most other antimicrobial agents. It is also active in vitro against some