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Impact of Disease on Amikacin Pharmacokinetics and Dosing in Children

Xiaoxi Liu1, Anne Smits2, Yuhuan Wang1

  • 1Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.

Therapeutic Drug Monitoring
|October 10, 2018
PubMed

Insights

Amikacin dosing needs adjustment based on disease in children. Burn patients require higher amikacin doses than cancer patients to achieve effective plasma concentrations, impacting treatment strategies.

Area of Science:

  • Pharmacology
  • Pediatric Medicine
  • Infectious Diseases

Background:

  • Amikacin is crucial for severe Gram-negative bacterial infections.
  • Peak plasma concentration correlates with amikacin efficacy.
  • Patient characteristics and disease influence amikacin pharmacokinetics (PK).

Purpose of the Study:

  • To assess amikacin PK in pediatric burn and cancer patients.
  • To identify clinical factors affecting amikacin PK in these populations.

Main Methods:

  • Retrospective analysis of amikacin PK data from 66 burn and 112 cancer children.
  • Population PK modeling using nonlinear mixed-effects (NONMEM 7.3).
  • Data processing and visualization with R packages.

Main Results:

  • A two-compartment model best described amikacin PK.
  • Disease condition significantly impacted PK: burn patients had higher clearance and V1.
  • Age, body weight, and creatinine clearance influenced Vd and clearance.

Conclusions:

  • Disease significantly alters amikacin PK in children.
  • Burn patients necessitate higher amikacin doses than cancer patients for target concentrations.
  • Further research is needed to validate dosing strategies and explore other conditions.
Abstract

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