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Pharmacokinetic analysis of amikacin twice and single daily dosage in immunocompromised pediatric patients.

Abstract
Ten children received amikacin twice daily and 13 were treated using the single daily protocol. All had fever and neutropenia on admission, and received a total daily dose of 20 mg/kg when included in the study. Individual pharmacokinetic parameters were calculated using a one-compartment model for two blood amikacin samples. The mean (+/- SD) of elimination half-life (h), amikacin clearance (l/h/kg), volume of distribution (l/kg), peak concentration (microgram/ml) and trough concentration (microgram/ml) were: 2.51 (0.74) and 2.85 (0.32) h; 0.26 (0.16) and 0.115 (0.02) l/h/kg; 0.74 (0.44) and 0.47 (0.11) l/kg; 19.1 (12.3) and 42.6 (12.6) micrograms/ml; 0.85 (0.74) and 0.18 (0.24) microgram/ml with twice and single daily dosage schedules, respectively. A single daily dose of amikacin had a significantly longer elimination half-life, lower clearance, higher peak concentration and lower trough concentration in comparison to the twice-daily schedule. The use of amikacin 20 mg/kg daily delivered in a single daily dose is recommended for immunocompromised pediatric patients with fever and neutropenia, in spite of the measured pharmacokinetic differences.
AuthorsN Krivoy, S Postovsky, R Elhasid, M W Ben Arush
JournalInfection (Infection) 1998 Nov-Dec Vol. 26 Issue 6 Pg. 396-8 ISSN: 0300-8126 [Print] Germany
PMID9861567 (Publication Type: Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Amikacin
Topics
  • Adolescent
  • Amikacin (administration & dosage, blood, pharmacokinetics)
  • Anti-Bacterial Agents (administration & dosage, blood, pharmacokinetics)
  • Bacterial Infections (drug therapy)
  • Child
  • Child, Preschool
  • Drug Administration Schedule
  • Female
  • Fever of Unknown Origin (complications)
  • Humans
  • Immunocompromised Host
  • Infant
  • Male
  • Neoplasms (complications)
  • Neutropenia (complications)

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