Pharmacokinetics and dosage regimens of amikacin in intensive care unit patients.
The pharmacokinetics of amikacin have been studied in 40 intensive care unit (ICU) patients using a two-compartment model and the Bayesian estimation method implemented in the USC PC-PACK program of Jelliffe et al. The volume of the central compartment was significantly higher in these patients (0.36 l.kg-1) than in the reference population (0.20 l.kg-1). A method has been designed to compute dosage regimens in order to maintain a constant steady-state average plasma concentration of 8 mg.l-1 for repeated i.v. infusions. The regimen calculated for the 'average' ICU patient varies between 11 mg.kg-1 three times per day for the patient with normal renal function and 6 mg.kg-1 every 2 days for the anuric patient. This regimen is intended to begin amikacin therapy in an ICU patient, while the population pharmacokinetic parameters would allow the individualization of the regimen by means of the Bayesian method.
Debord
J
J
Service de Pharmacologie et Toxicologie, C.H.R.U. Dupuytren, Limoges, France.
Voultoury
J C
JC
Lachatre
G
G
Favereau
J P
JP
Gay
R
R
D000583:Amikacin / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D001002:Anuria / Q000378:metabolism; D001499:Bayes Theorem; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D004360:Drug Therapy, Computer-Assisted; D006207:Half-Life; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney / Q000378:metabolism; D012984:Software
D000583:Amikacin; D003404:Creatinine