Aminoglycosides for treatment of bacteremia due to carbapenem-resistant Klebsiella pneumoniae

Abstract

Aminoglycoside treatment of carbapenem-resistant (CR) Klebsiella pneumoniae bacteremia was associated with a 70% rate (23/ 33) of 30-day survival. Successful treatment was associated with sources of bacteremia amenable to reliable aminoglycoside pharmacokinetics (P = 0.037), acute physiology and chronic health evaluation II (APACHE II) scores of < 20 (P =0.16), and nonfatal underlying diseases (P = 0.015). Success rates were 78% and 100% if ≥ 2 and all 3 factors were present, respectively. Clinicians may consider the use of aminoglycosides against CR K. pneumoniae bacteremia if strains are susceptible and the sources of infection are amenable to reliable pharmacokinetics.