Effect of 'high-dose' amikacin in children

17 children with serious infections were treated for an average period of 9.5 days with 420 mg/m2/dose of amikacin every 8 h. The nephrotoxicity and ototoxicity of this 'high-dose' regimen was studied. None of the children had evidence of nephrotoxicity. Of 9 children who could be clearly evaluated, 1 child experienced a delayed transient auditory dysfunction. 1 child experienced delayed serious deafness, but was receiving other ototoxic drugs. Despite the fact that the doses averaged 54.1 mg/kg/day, 5 children in our series had peak concentrations lower than that recommended for adults with serious infection.