暂无摘要。

This surveillance made possible an immediate check up for an appropriate use of guidelines, allowing an optimal usage of antimicrobial agents. It\'s interest at term is to document audits (yearly for example) to discuss the effectiveness of our guidelines and, if necessary, to make new therapeutic choices, proven to be effective after investigation for clinical and microbiological data. Our surveillance system can be easily investigated by the physicians. It consists in checking on a weekly sheet all the new antimicrobial therapy courses, with name of patient, age, cause of antimicrobial therapy and hospitalization, bacteria, antibiotics used, for infection, before superinfection, previous superinfection, prophylaxis. A shift in usage of antibiotics can be observed, with consequences in antimicrobial therapy and hospital hygiene.

Amikacin is a new aminoglycoside antibiotic that behaves pharmacokinetically similar to kanamycin, gentamicin, and tobramycin. Our study was designed to test whether a digital computer program could correctly predict amikacin serum concentrations in the clinical setting. A significant relation (P less than 0.0001) was found between 153 measured (bioassayed) and computer-predicted levels from 26 patients. The computer program reliably estimated amikacin serum levels after either intravenous or intramuscular doses. Prediction accuracy was not significantly affected by patient sex, hematocrit, or periods of unstable renal function. Predicted levels were most accurate when based on creatinine clearance corrected to 70 kg body weight or corrected to body surface area. The pharmacokinetic parameters in the computer program were used to generate a new aminoglycoside dosing chart. Ten patients were given amikacin according to this guideline, and the mean peak serum level for the group was 25.6 microgram/ml.