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Increased amikacin dosage requirements in burn patients receiving a once-daily regimen

J M Conil1, B Georges, A Breden

  • 1Service d'Anesthésie-Réanimation, Hôpital de Rangueil, Toulouse, France. conil.jm@chu-toulouse.fr

International Journal of Antimicrobial Agents
|August 16, 2006
PubMed

Insights

Burn patients often need higher amikacin (AMK) doses than typically prescribed. Dosing adjustments for AMK in burn patients are crucial for achieving therapeutic antibiotic concentrations and ensuring patient safety.

Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Altered pharmacokinetics in burn patients can impact antibiotic plasma concentrations.
  • Standard once-daily dosing (ODD) of amikacin (AMK) may not achieve target peak concentrations (Cmax) in burn patients.

Purpose of the Study:

  • To evaluate amikacin (AMK) plasma concentrations in burn patients.
  • To identify factors influencing AMK pharmacokinetics in this population.

Main Methods:

  • Recorded plasma concentrations after administering 20 mg/kg AMK to burn patients.
  • Analyzed relationships between Cmax, amikacin clearance (Cl), burn characteristics, and creatinine clearance (ClCR).

Main Results:

  • Mean Cmax was 48.3±10.8 mg/L, with a Cmax/MIC ratio of 6±1.35.
  • Cmax correlated with burn area and Unit Burn Standard.
  • AMK clearance was associated with creatinine clearance (ClCR).

Conclusions:

  • Once-daily dosing (ODD) regimens of AMK may require doses exceeding 20 mg/kg for burn patients with burns >15% body surface area or ClCR >120 mL/min.
  • Therapeutic drug monitoring is essential for safe and effective amikacin dosing in burn patients.

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