Individualizing amikacin regimens: accurate method to achieve therapeutic concentrations.
Amikacin's pharmacokinetics and dosage requirements were studied in 98 patients receiving treatment for gram-negative infections. A wide interpatient variation in the kinetic parameters of the drug occurred in all patients and in patients who had normal serum creatinine levels or normal creatinine clearance. The half-life ranged from 0.7 to 14.4 h in 74 patients who had normal serum creatinine levels and from 0.7 to 7.2 h in 37 patients who had normal creatinine clearance. The necessary daily dose to obtain therapeutic serum concentrations ranged from 1.25 to 57 mg/kg in patients with normal serum creatinine levels and from 10 to 57 mg/kg in patients with normal creatinine clearance. In four patients (4%), a significant change in baseline serum creatinine level (greater than 0.5 mg/dl) occurred during or after treatment, which may have been amikacin-associated toxicity. Overt ototoxicity occurred in one patient. The method of individualizing dosage regimens provided a clinically useful means of rapidly attaining therapeutic peak and trough serum concentrations.
Zaske
D E
DE
Department of Surgery, School of Medicine, St. Paul, Minnesota.
Cipolle
R J
RJ
Rotschafer
J C
JC
Kohls
P R
PR
Strate
R G
RG
D000328:Adult; D000368:Aged; D000375:Aging / Q000378:metabolism; D000583:Amikacin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D014644:Genetic Variation / Q000502:physiology; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D007668:Kidney / Q000502:physiology; D008297:Male; D008875:Middle Aged; D008954:Models, Biological
D000583:Amikacin