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Individualizing amikacin regimens: accurate method to achieve therapeutic concentrations
D E Zaske1, R J Cipolle, J C Rotschafer
1Department of Surgery, School of Medicine, St. Paul, Minnesota.
Therapeutic Drug Monitoring
|November 1, 1991
Summary
Amikacin dosing requires careful consideration due to significant interpatient variability in pharmacokinetics. Individualizing amikacin dosage regimens is crucial for achieving therapeutic drug concentrations and minimizing toxicity risks.
Area of Science:
- Pharmacology
- Infectious Diseases
- Nephrology
Background:
- Amikacin is a critical antibiotic for treating gram-negative infections.
- Understanding its pharmacokinetic variability is essential for effective treatment.
Purpose of the Study:
- To investigate amikacin pharmacokinetics and dosage requirements in patients with gram-negative infections.
- To assess the impact of renal function on amikacin dosing.
Main Methods:
- Studied 98 patients undergoing amikacin treatment.
- Analyzed pharmacokinetic parameters including half-life and required daily dosage.
- Monitored serum creatinine levels for potential toxicity.
Main Results:
- Observed wide interpatient variation in amikacin's kinetic parameters.
- Half-life varied significantly even in patients with normal renal function.
- Daily dosage requirements showed considerable range (1.25–57 mg/kg).
- Four patients (4%) experienced potential amikacin-associated renal toxicity.
- One patient developed overt ototoxicity.
Conclusions:
- Amikacin pharmacokinetics exhibit substantial interpatient variability.
- Individualized dosing regimens are necessary to achieve therapeutic amikacin serum concentrations.
- Close monitoring for amikacin-associated toxicity, including renal and ototoxicity, is recommended.