title: Pharmacokinetic analysis of amikacin twice and single daily dosage in immunocompromised pediatric patients.
abstract: Ten children received amikacin twice daily and 13 were treated using the single daily protocol. All had fever and neutropenia on admission, and received a total daily dose of 20 mg/kg when included in the study. Individual pharmacokinetic parameters were calculated using a one-compartment model for two blood amikacin samples. The mean (+/- SD) of elimination half-life (h), amikacin clearance (l/h/kg), volume of distribution (l/kg), peak concentration (microgram/ml) and trough concentration (microgram/ml) were: 2.51 (0.74) and 2.85 (0.32) h; 0.26 (0.16) and 0.115 (0.02) l/h/kg; 0.74 (0.44) and 0.47 (0.11) l/kg; 19.1 (12.3) and 42.6 (12.6) micrograms/ml; 0.85 (0.74) and 0.18 (0.24) microgram/ml with twice and single daily dosage schedules, respectively. A single daily dose of amikacin had a significantly longer elimination half-life, lower clearance, higher peak concentration and lower trough concentration in comparison to the twice-daily schedule. The use of amikacin 20 mg/kg daily delivered in a single daily dose is recommended for immunocompromised pediatric patients with fever and neutropenia, in spite of the measured pharmacokinetic differences.
authors.affiliation: Pediatric Hemato-Oncology Unit, B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Rambam Medical Center, Haifa, Israel.
authors.forename: N
authors.initials: N
authors.lastname: Krivoy
authors.forename: S
authors.initials: S
authors.lastname: Postovsky
authors.forename: R
authors.initials: R
authors.lastname: Elhasid
authors.forename: M W
authors.initials: MW
authors.lastname: Ben Arush
mesh_terms: D000293:Adolescent; D000583:Amikacin / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D001424:Bacterial Infections / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D005335:Fever of Unknown Origin / Q000150:complications; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin