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A comparison of two amikacin dosing regimens in paediatric surgical patients

N B Forsyth1, J H Botha, G P Hadley

  • 1Department of Experimental and Clinical Pharmacology, Faculty of Medicine, University of Natal, Durban, South Africa.

Annals of Tropical Paediatrics
|January 13, 1998
PubMed

Insights

This study compared once-daily versus twice-daily amikacin dosing in pediatric surgical patients. Both regimens showed similar efficacy and low toxicity, suggesting flexibility in amikacin administration for critically ill children.

Area of Science:

  • Pediatric Surgery
  • Pharmacology
  • Critical Care Medicine

Background:

  • Amikacin is a crucial antibiotic for treating serious bacterial infections in critically ill patients.
  • Optimizing amikacin dosing is essential to balance efficacy and minimize toxicity in pediatric surgical populations.

Purpose of the Study:

  • To compare the efficacy and toxicity of once-daily versus twice-daily intravenous amikacin regimens.
  • To evaluate clinical outcomes, nephrotoxicity, and ototoxicity in pediatric surgical patients receiving different amikacin schedules.

Main Methods:

  • A comparative study involving pediatric surgical patients (0.6-12 years) receiving amikacin intravenously.
  • Two groups were formed: once-daily (15 mg/kg) and twice-daily (7.5 mg/kg) dosing.
  • Efficacy assessed via temperature, clinical improvement, and white cell counts; toxicity evaluated by serum creatinine and audiometry.

Main Results:

  • Mean peak serum amikacin levels were significantly higher in the once-daily group (37.7 mg/l) compared to the twice-daily group (19.5 mg/l).
  • Favorable outcomes were observed in 18/24 (once-daily) and 22/25 (twice-daily) patients, with no statistically significant difference.
  • No significant nephrotoxicity was detected; mild, reversible high-frequency hearing deficits occurred in a small percentage of patients in both groups.

Conclusions:

  • Both once-daily and twice-daily amikacin regimens demonstrated comparable efficacy and acceptable safety profiles in seriously ill pediatric surgical patients.
  • The findings suggest potential flexibility in amikacin dosing strategies for this patient population.
  • Further research is warranted to definitively establish the optimal amikacin dosing approach in pediatric patients.

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