The mortality for carbapenem-resistant Klebsiella pneumoniae (KPC-Kp) infection ranges from 18 to 48% depending on the type of therapy. Mortality rates in hematologic patients are even higher, up to 85%. Gut decontamination with oral gentamicin might be an option to avoid a subsequent KPC-Kp infection in colonized patients. We treated 14 hematologic patients with oral gentamicin, 80 mg four times daily, for 7 to 25 days in order to eradicate KPC-Kp from the gut, starting oral gentamicin therapy when possible after the discontinuation of systemic antibiotic therapy. The overall decontamination rate in the entire study population was 71% (10/14). Out of the 4 patients who did not respond to oral gentamicin therapy, 1 KPC-Kp strain was gentamicin resistant and 4 patients received concomitant systemic antibiotic therapy (CSAT). One of these patients died from KPC-Kp sepsis. The decontamination rate was 90% (9/10) in patients receiving oral gentamicin only, versus 25% (1/4) in those also treated with CSAT. No new gentamicin-resistant KPC-Kp strain was isolated during oral gentamicin therapy. Oral gentamicin might be useful for gut decontamination and prevention of KPC-Kp infection. This option should be considered in patients colonized by a gentamicin-susceptible KPC-Kp strain and not receiving CSAT.
|Autori:||Lambelet, Paola; Tascini, Carlo; FORTUNATO, SIMONA; Stefanelli, Alessandro; Simonetti, Federico; Vettori, Chiara; Leonildi, Alessandro; MENICHETTI, FRANCESCO|
|Titolo:||Oral gentamicin therapy for Carbapenem-resistant Klebsiella pneumoniae gut colonization in hematologic patients: a single center experience|
|Anno del prodotto:||2017|
|Appare nelle tipologie:||1.1 Articolo in rivista|
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