Impact of 30 mg/kg amikacin and 8 mg/kg gentamicin on serum concentrations in critically ill patients with severe sepsis

Roger, Claire, Nucci, Bastian, Louart, Benjamin, Friggeri, Arnaud, Knani, Haroun, Evrard, Alexandre, Lavigne, Jean-Philippe, Allaouchiche, Bernard, Lefrant, Jean-Yves, Roberts, Jason A. and Muller, Laurent (2016) Impact of 30 mg/kg amikacin and 8 mg/kg gentamicin on serum concentrations in critically ill patients with severe sepsis. Journal of Antimicrobial Chemotherapy, 71 1: 208-212. doi:10.1093/jac/dkv291


Author Roger, Claire
Nucci, Bastian
Louart, Benjamin
Friggeri, Arnaud
Knani, Haroun
Evrard, Alexandre
Lavigne, Jean-Philippe
Allaouchiche, Bernard
Lefrant, Jean-Yves
Roberts, Jason A.
Muller, Laurent
Title Impact of 30 mg/kg amikacin and 8 mg/kg gentamicin on serum concentrations in critically ill patients with severe sepsis
Journal name Journal of Antimicrobial Chemotherapy   Check publisher's open access policy
ISSN 1460-2091
0305-7453
Publication date 2016-01-01
Year available 2015
Sub-type Article (original research)
DOI 10.1093/jac/dkv291
Open Access Status Not Open Access
Volume 71
Issue 1
Start page 208
End page 212
Total pages 5
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Subject 3004 Pharmacology
2736 Pharmacology (medical)
2725 Infectious Diseases
Abstract Objectives:Low first-dose peak serum concentrations of amikacin and gentamicin are commonly reported in ICU patients. The present study aimed to assess whether 30 mg/kg amikacin or 8 mg/kg gentamicin achieved target concentrations in ICU patients with severe sepsis.
Formatted abstract
Objectives: Low first-dose peak serum concentrations of amikacin and gentamicin are commonly reported in ICU patients. The present study aimed to assess whether 30 mg/kg amikacin or 8 mg/kg gentamicin achieved target concentrations in ICU patients with severe sepsis.

Patients and methods: Sixty-three ICU patients (Simplified Acute Physiology Score II = 43 ± 16) with severe sepsis and an indication for intravenous amikacin (n = 47) or gentamicin (n = 16) were included. The first (30 mg/kg amikacin; 8 mg/kg gentamicin) and subsequent doses and corresponding peak concentrations (30 min after the completion of an infusion) were recorded. French guideline target concentrations were ≥60 and ≥30 mg/L for amikacin and gentamicin, respectively. A target pharmacokinetic/pharmacodynamic ratio of 10 × MIC was also measured.

Results: Pulmonary, abdominal and urinary tract infections were diagnosed in 56 patients. Infection was confirmed in 37 patients (59%). The targeted first-dose peak concentration was achieved in 37/63 patients (59%) [amikacin 36/47 (77%) and gentamicin 1/16 (6%)], and 59/63 patients (94%) achieved the pharmacokinetic/pharmacodynamic ratio using the MIC data that were available from 21 patients. However, the second dose of aminoglycoside was withheld because of high trough concentrations in nearly half of patients who did not have renal dysfunction.

Conclusions: In this study, 30 mg/kg amikacin and 8 mg/kg gentamicin led to target peak serum concentrations in 59% of patients.
Keyword Infectious Diseases
Microbiology
Pharmacology & Pharmacy
Infectious Diseases
Microbiology
Pharmacology & Pharmacy
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID APP1048652
Institutional Status UQ
Additional Notes Published online 1 October 2015

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
School of Pharmacy Publications
 
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