title: [Amikacin pharmacokinetics in adults: a variability that question the dose calculation based on weight].
abstract: The use of amikacin is difficult because of its toxicity and its pharmacokinetic variability. This variability is almost ignored in adult standard dosage regimens since only the weight is used in the dose calculation. Our objective is to test if the pharmacokinetic of amikacin can be regarded as homogenous, and if the method for calculating the dose according to patients' weight is appropriate. From a cohort of 580 patients, five groups of patients were created by statistical data partitioning. A population pharmacokinetic analysis was performed in each group. The adult population is not homogeneous in term of pharmacokinetics. The doses required to achieve a maximum concentration of 60 mg/L are strongly different (585 to 1507 mg) between groups. The exclusive use of the weight to calculate the dose of amikacine appears inappropriate for 80% of the patients, showing the limits of the formulae for calculating doses of aminoglycosides.
authors.affiliation: Université de Lyon 1, Ecole Doctorale E2M2 Evolution, Ecosystèmes, Microbiologie, Modélisation, UMR 5558, Biométrie et Biologie Evolutive, Villeurbanne, France. laurent.bourguignon@chu-lyon.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Bourguignon
authors.forename: Sylvain
authors.initials: S
authors.lastname: Goutelle
authors.forename: Cécile
authors.initials: C
authors.lastname: Gérard
authors.forename: Anne
authors.initials: A
authors.lastname: Guillermet
authors.forename: Julie
authors.initials: J
authors.lastname: Burdin de Saint Martin
authors.forename: Pascal
authors.initials: P
authors.lastname: Maire
authors.forename: Michel
authors.initials: M
authors.lastname: Ducher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000583:Amikacin / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D001835:Body Weight / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin