[Interindividual pharmacokinetic variability in long-term antibiotherapy].
OBJECTIVE
The authors wanted to assess intraindividual pharmacokinetic variability, with a case of long-term amikacin therapy.


METHODS
A 92-year-old female patient, weighing 44kg, with renal failure, was treated by amikacin for 52 days. Her individual pharmacokinetic parameters were assessed 12 times in the course of therapy. The intraindividual variability of key parameters was quantified and compared with published interindividual variability.


RESULTS
Intraindividual volume and clearance variability was measured at about one fourth to one third of the value observed for interindividual variability. Half-life intraindividual variability was almost equivalent to the interindividual variability: 24.5% versus 32%.


CONCLUSIONS
The high pharmacokinetic variability observed has important potential clinical consequences. This case illustrates the need to ensure the effectiveness of treatment, to re-evaluate periodically the patient's status in order to take into account the intraindividual variability of pharmacokinetics parameters.
Bourguignon
L
L
Université Lyon-1, UMR CNRS 5558, biométrie et biologie évolutive, bâtiment G.-Mendel, 43, boulevard du 11-Novembre-1918, 69622 Villeurbanne cedex, France. laurent.bourguignon@chu-lyon.fr
Goutelle
S
S
de Saint Martin
J Burdin
JB
Guillermet
A
A
Bouniot
P
P
Maire
P
P
Ducher
M
M
D000369:Aged, 80 and over; D000583:Amikacin / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D013997:Time Factors
D000900:Anti-Bacterial Agents; D000583:Amikacin