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Single daily dose amikacin in paediatric patients with severe gram-negative infections
H Trujillo1, J Robledo, C Robledo
1Hospital Pablo Tobon Uribe, Medellin, Colombia.
Insights
A prospective study found that a single daily dose of amikacin (20 mg/kg) is safe and effective for treating serious Gram-negative infections in children. All patients achieved clinical and bacteriological cure with no significant adverse reactions observed.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology and Therapeutics
Background:
- Serious Gram-negative bacterial infections pose a significant threat to pediatric patients.
- Effective and safe antibiotic regimens are crucial for managing these infections in children.
Purpose of the Study:
- To evaluate the safety and efficacy of a single daily dose of amikacin in pediatric patients with serious Gram-negative infections.
- To assess amikacin pharmacokinetic parameters and clinical outcomes in this population.
Main Methods:
- A prospective study involving 25 children with serious Gram-negative infections.
- Treatment involved amikacin (20 mg/kg) as a single daily intravenous infusion for 4–12 days, sometimes combined with beta-lactam antibiotics.
- Bacterial isolates included Escherichia coli, K. pneumoniae, Providencia, Enterobacter, and Pseudomonas aeruginosa.
Main Results:
- All 25 patients achieved clinical and bacteriologic cure.
- Mean peak amikacin concentrations ranged from 49 to 53.6 mg/l, and trough concentrations ranged from 6 to 7.7 mg/l.
- No significant adverse reactions were observed during the treatment period.
Conclusions:
- A single daily dose of 20 mg/kg amikacin appears to be a practical and safe treatment option for serious Gram-negative infections in children.
- Further research is warranted to confirm these findings and explore optimal dosing strategies.
Abstract:
Twenty-five children with serious Gram-negative infections were treated in a prospective study with amikacin 20 mg/kg administered in a single daily dose as a 30 min iv infusion for 4 to 12 days. In nine cases the amikacin was combined with beta-lactam antibiotics. Escherichia coli were the most frequent bacteria isolated followed by K. pneumoniae, Providencia and Enterobacter spp. and Pseudomonas aeruginosa with MICs ranging from 1 to 16 mg/l. Mean (+/- S.D.) peak and trough concentrations of days 1 and 4 of therapy ranged from 49 +/- 13.5 to 53.6 +/- 13.4 mg/l and 6 + 1.4 to 7.7 +/- 4.1 mg/l respectively. All patients were clinically and bacteriologically cured. No significant adverse reactions were observed. The results suggest that administration of a single daily dose of 20 mg/kg amikacin should be considered practical and safe in children. Further studies are needed.