High-dose amikacin for achieving serum target levels in critically ill elderly patients

Infection and Drug Resistance
Kourosh SadeghiMojtaba Mojtahedzadeh

Abstract

To achieve target concentrations, the application of higher-than-standard doses of amikacin is proposed for the treatment of sepsis due to an increase in volume of distribution and clearance, but little data are available on aminoglycoside administration in critically ill elderly patients. Forty critically ill elderly patients (aged over 65 years) who required amikacin therapy due to severe documented, or suspected gram-negative infections, were randomly assigned to two treatment groups. Group A (20 patients) received 15 mg/kg amikacin and Group B (20 patients) received 25 mg/kg amikacin per day as a single daily dose. All the patients were monitored for renal damage by the daily monitoring of serum creatinine. The amikacin peak (Cmax) and trough (Cmin) serum concentrations were measured on Days 3 and 7 postadministration. Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmaxlevels in the standard and high-dose treatment groups were 30.4±11 and 52.3±16.1 µg/mL (P<0.001), and the Cminlevels were 3.2±2.1 and 5.2±2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmaxlevels in the standard and high-dose groups were 33±7.3 and 60.0±17.6 µg/mL (P=0.001), and the Cminlevels ...Continue Reading

Citations

Jun 2, 2020·Therapeutic Delivery·Babak Faraji DizajiMohammad Reza Asgary
May 5, 2020·The Journal of Antimicrobial Chemotherapy·Jonás Samuel Pérez-BlancoAna Martín-Suárez
Feb 1, 2020·Advanced Pharmaceutical Bulletin·Bita ShahramiMojtaba Mojtahedzadeh
Jan 31, 2021·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Roccaldo SardellaStefano Giovagnoli
Oct 1, 2021·European Journal of Hospital Pharmacy. Science and Practice·Saeideh GhaffariMojtaba Mojtahedzadeh
Nov 10, 2021·Therapeutic Drug Monitoring·Dario CattaneoDeborah J E Marriott

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Methods Mentioned

BETA
urine collection

Software Mentioned

SPSS

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Aminoglycosides (ASM)

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.

Aminoglycosides

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.