Influence of sepsis on higher daily dose of amikacin pharmacokinetics in critically ill patients.

Abstract:

BACKGROUND AND OBJECTIVES:Severe sepsis is a major problem as cause of high rates morbidity and mortality in intensive care units (ICU). Aminoglycosides are an important group of antimicrobials used for severe sepsis. However, aminoglycoside pharmacokinetics in ICU patients may be altered during sepsis, which can affect the drug concentrations. Therefore, this study was undertaken to examine the relationship between amikacin disposition kinetics after a 25 mg/kg loading dose and hemodynamic response to sepsis, as well as clinical parameters, in a population of critically ill patients. METHODS:In this work, 30 patients who were candidate to amikacin therapy following Gram negative sepsis were enrolled. The pharmacokinetic profile of amikacin by a non-compartmental model was calculated for each patient. RESULTS:Mean volume of distribution was 0.36 ± 0.07 L/kg and mean serum amikacin clearance was 3.88 ± 0.97 ml/min/kg. In the case of Vd, APACHE II score correlation was significant. In the case of amikacin clearance, two covariates including creatinine clearance and Sr Cr significant correlation was found. CONCLUSIONS:It appears necessary to use higher amikacin dosage (≥ 25 mg/kg) considering hemodynamic response of patients to sepsis. To achieve therapeutic drug concentration a close drug monitoring and a shift from the population mean toward a value more representative of the critically ill patient subpopulation is crucial.  

authors

Mahmoudi L,Mohammadpour AH,Ahmadi A,Niknam R,Mojtahedzadeh M

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

285-91

issue

3

eissn

1128-3602

issn

2284-0729

journal_volume

17

pub_type

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