[Amikacin pharmacokinetics in adults: a variability that question the dose calculation based on weight]

Therapie. 2009 Jan-Feb;64(1):47-53. doi: 10.2515/therapie/2009009. Epub 2009 May 26.
[Article in French]

Abstract

The use of amikacin is difficult because of its toxicity and its pharmacokinetic variability. This variability is almost ignored in adult standard dosage regimens since only the weight is used in the dose calculation. Our objective is to test if the pharmacokinetic of amikacin can be regarded as homogenous, and if the method for calculating the dose according to patients' weight is appropriate. From a cohort of 580 patients, five groups of patients were created by statistical data partitioning. A population pharmacokinetic analysis was performed in each group. The adult population is not homogeneous in term of pharmacokinetics. The doses required to achieve a maximum concentration of 60 mg/L are strongly different (585 to 1507 mg) between groups. The exclusive use of the weight to calculate the dose of amikacine appears inappropriate for 80% of the patients, showing the limits of the formulae for calculating doses of aminoglycosides.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Amikacin / administration & dosage*
  • Amikacin / pharmacokinetics*
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacokinetics*
  • Body Weight / physiology*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged

Substances

  • Anti-Bacterial Agents
  • Amikacin