Amikacin pharmacokinetic/pharmacodynamic in intensive care unit: a prospective database

Annals of Intensive Care
Elsa LogreOlivier Pajot

Abstract

Aminoglycosides have a concentration-dependent therapeutic effect when peak serum concentration (Cmax) reaches eight to tenfold the minimal inhibitory concentration (MIC). With an amikacin MIC of 8 mg/L, the Cmax should be 64-80 mg/L. This objective is based on clinical breakpoints and not on measured MIC. This study aimed to assess the proportion of patients achieving the pharmacokinetic/pharmacodynamic (PK/PD) target Cmax/MIC ≥ 8 using the measured MIC in critically ill patients treated for documented Gram-negative bacilli (GNB) infections. Retrospective analysis from February 2016 to December 2017 of a prospective database conducted in 2 intensive care units (ICU). All patients with documented severe GNB infections treated with amikacin (single daily dose of 25 mg/kg of total body weight (TBW)) with both MIC and Cmax measurements at first day of treatment (D1) were included. Results are expressed in n (%) or median [min-max]. 93 patients with 98 GNB-documented infections were included. The median Cmax was 55.2 mg/L [12.2-165.7] and the median MIC was 2 mg/L [0.19-16]. Cmax/MIC ratio ≥ 8 was achieved in 87 patients (88.8%) while a Cmax ≥ 64 mg/L was achieved in only 38 patients (38.7%). Overall probability of PK/PD target att...Continue Reading

References

Feb 27, 1999·Antimicrobial Agents and Chemotherapy·A D KashubaJ S Bertino
May 1, 1999·Antimicrobial Agents and Chemotherapy·M P Mingeot-Leclercq, P M Tulkens
Apr 8, 2010·Critical Care : the Official Journal of the Critical Care Forum·Fabio Silvio TacconeFrédérique Jacobs
May 27, 2011·International Journal of Antimicrobial Agents·Ricardo GálvezJosé Castro
Jul 28, 2013·Critical Care : the Official Journal of the Critical Care Forum·Wieslawa DuszynskaAndrzej Kübler
Apr 29, 2014·The Lancet Infectious Diseases·Jason A RobertsUNKNOWN International Society of Anti-Infective Pharmacology and the Pharmacokinetics and Pharmacodynamics Study Group of the Europe
Oct 3, 2015·The Journal of Antimicrobial Chemotherapy·Claire RogerLaurent Muller
Nov 4, 2016·Annals of Intensive Care·Nicolas AllouPascal Augustin
Jan 20, 2017·Intensive Care Medicine·Andrew RhodesR Phillip Dellinger
Apr 17, 2018·Fundamental & Clinical Pharmacology·Clément BoidinArnaud Friggeri

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