[Dynamic changes of blister fluid amikacin concentration after its early-stage administration in severely burned patients].
OBJECTIVE
To determine the adequate timing of antibiotics application in severely burned patients by observing the dynamic changes of amikacin in blister fluid during early postburn stage.


METHODS
Twenty patients in early stage of sever burns were divided into 4 groups (n=5) according to the timing of amikacin administration, namely at 3-4 h (group A), 10 h (group B, 20 h (group C), and 30 h (group D) postburn. Amikacin was administered intravenously via a single dose of 400 mg within 30 min, and at the time points of 0.25 to 7 h after completion of the infusion, the blister fluid was collected from each patient for determination of amikacin concentration with fluorescence polarization immunoassay.


RESULTS
Fifteen minutes after intravenous administration, amikacin could be detected in the blister fluid, reaching the highest level at 1-2 h after administration followed by gradual declination. In group B, blister fluid amikacin concentration reached 4.96+1.60 microg/ml 15 min after administration, and at the subsequent time points until 4 h, amikacin concentration was significantly higher in groups A and B than in groups C and D (P<0.05). Amikacin concentration in the blister fluid in group D was not sufficient for effective antibacterial therapy.


CONCLUSIONS
Amikacin administration in the early postburn stage may ensure higher amikacin concentration in the blister fluid and wound exudate. Better antibacterial effect can be expected when amikacin is applied within the initial 10 h postburn.
Hua
Rong
R
Department of Burns, First People's Hospital of Guangzhou, Guangzhou Medical College, Guangzhou 510180, China. hzr19810915@ sohu.com
Rong
Xin-Zhou
XZ
Zhang
Tao
T
Yang
Rong-Hua
RH
D000328:Adult; D000583:Amikacin / Q000008:administration & dosage* / Q000032:analysis*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000032:analysis*; D001768:Blister / Q000188:drug therapy* / Q000473:pathology; D002056:Burns / Q000188:drug therapy* / Q000473:pathology; D005122:Exudates and Transudates / Q000737:chemistry*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D055815:Young Adult
D000900:Anti-Bacterial Agents; D000583:Amikacin