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

Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Sadeghi K [verfasserIn] Hamishehkar H [verfasserIn] Najmeddin F [verfasserIn] Ahmadi A [verfasserIn] Hazrati E [verfasserIn] Honarmand H [verfasserIn] Mojtahedzadeh M [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2018

Schlagwörter:	amikacin elderly high-dose critical illness pharmacokinetics therapeutic drug monitoring

Übergeordnetes Werk:	In: Infection and Drug Resistance - Dove Medical Press, 2009, (2018), Seite 223-228
Übergeordnetes Werk:	year:2018 ; pages:223-228

Links:	Link aufrufen Link aufrufen Journal toc

Katalog-ID:	DOAJ034118047

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allfields	(DE-627)DOAJ034118047 (DE-599)DOAJ741443507a8b4c7aa3daf847b6c28b97 DE-627 ger DE-627 rakwb eng RC109-216 Sadeghi K verfasserin aut High-dose amikacin for achieving serum target levels in critically ill elderly patients 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring amikacin elderly high-dose critical illness pharmacokinetics therapeutic drug monitoring Infectious and parasitic diseases Hamishehkar H verfasserin aut Najmeddin F verfasserin aut Ahmadi A verfasserin aut Hazrati E verfasserin aut Honarmand H verfasserin aut Mojtahedzadeh M verfasserin aut In Infection and Drug Resistance Dove Medical Press, 2009 (2018), Seite 223-228 (DE-627)600305996 (DE-600)2494856-1 11786973 nnns year:2018 pages:223-228 https://doaj.org/article/741443507a8b4c7aa3daf847b6c28b97 kostenfrei https://www.dovepress.com/high-dose-amikacin-for-achieving-serum-target-levels-in-critically-ill-peer-reviewed-article-IDR kostenfrei https://doaj.org/toc/1178-6973 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 223-228
spelling	(DE-627)DOAJ034118047 (DE-599)DOAJ741443507a8b4c7aa3daf847b6c28b97 DE-627 ger DE-627 rakwb eng RC109-216 Sadeghi K verfasserin aut High-dose amikacin for achieving serum target levels in critically ill elderly patients 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring amikacin elderly high-dose critical illness pharmacokinetics therapeutic drug monitoring Infectious and parasitic diseases Hamishehkar H verfasserin aut Najmeddin F verfasserin aut Ahmadi A verfasserin aut Hazrati E verfasserin aut Honarmand H verfasserin aut Mojtahedzadeh M verfasserin aut In Infection and Drug Resistance Dove Medical Press, 2009 (2018), Seite 223-228 (DE-627)600305996 (DE-600)2494856-1 11786973 nnns year:2018 pages:223-228 https://doaj.org/article/741443507a8b4c7aa3daf847b6c28b97 kostenfrei https://www.dovepress.com/high-dose-amikacin-for-achieving-serum-target-levels-in-critically-ill-peer-reviewed-article-IDR kostenfrei https://doaj.org/toc/1178-6973 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 223-228
allfields_unstemmed	(DE-627)DOAJ034118047 (DE-599)DOAJ741443507a8b4c7aa3daf847b6c28b97 DE-627 ger DE-627 rakwb eng RC109-216 Sadeghi K verfasserin aut High-dose amikacin for achieving serum target levels in critically ill elderly patients 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring amikacin elderly high-dose critical illness pharmacokinetics therapeutic drug monitoring Infectious and parasitic diseases Hamishehkar H verfasserin aut Najmeddin F verfasserin aut Ahmadi A verfasserin aut Hazrati E verfasserin aut Honarmand H verfasserin aut Mojtahedzadeh M verfasserin aut In Infection and Drug Resistance Dove Medical Press, 2009 (2018), Seite 223-228 (DE-627)600305996 (DE-600)2494856-1 11786973 nnns year:2018 pages:223-228 https://doaj.org/article/741443507a8b4c7aa3daf847b6c28b97 kostenfrei https://www.dovepress.com/high-dose-amikacin-for-achieving-serum-target-levels-in-critically-ill-peer-reviewed-article-IDR kostenfrei https://doaj.org/toc/1178-6973 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 223-228
allfieldsGer	(DE-627)DOAJ034118047 (DE-599)DOAJ741443507a8b4c7aa3daf847b6c28b97 DE-627 ger DE-627 rakwb eng RC109-216 Sadeghi K verfasserin aut High-dose amikacin for achieving serum target levels in critically ill elderly patients 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring amikacin elderly high-dose critical illness pharmacokinetics therapeutic drug monitoring Infectious and parasitic diseases Hamishehkar H verfasserin aut Najmeddin F verfasserin aut Ahmadi A verfasserin aut Hazrati E verfasserin aut Honarmand H verfasserin aut Mojtahedzadeh M verfasserin aut In Infection and Drug Resistance Dove Medical Press, 2009 (2018), Seite 223-228 (DE-627)600305996 (DE-600)2494856-1 11786973 nnns year:2018 pages:223-228 https://doaj.org/article/741443507a8b4c7aa3daf847b6c28b97 kostenfrei https://www.dovepress.com/high-dose-amikacin-for-achieving-serum-target-levels-in-critically-ill-peer-reviewed-article-IDR kostenfrei https://doaj.org/toc/1178-6973 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 223-228
allfieldsSound	(DE-627)DOAJ034118047 (DE-599)DOAJ741443507a8b4c7aa3daf847b6c28b97 DE-627 ger DE-627 rakwb eng RC109-216 Sadeghi K verfasserin aut High-dose amikacin for achieving serum target levels in critically ill elderly patients 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring amikacin elderly high-dose critical illness pharmacokinetics therapeutic drug monitoring Infectious and parasitic diseases Hamishehkar H verfasserin aut Najmeddin F verfasserin aut Ahmadi A verfasserin aut Hazrati E verfasserin aut Honarmand H verfasserin aut Mojtahedzadeh M verfasserin aut In Infection and Drug Resistance Dove Medical Press, 2009 (2018), Seite 223-228 (DE-627)600305996 (DE-600)2494856-1 11786973 nnns year:2018 pages:223-228 https://doaj.org/article/741443507a8b4c7aa3daf847b6c28b97 kostenfrei https://www.dovepress.com/high-dose-amikacin-for-achieving-serum-target-levels-in-critically-ill-peer-reviewed-article-IDR kostenfrei https://doaj.org/toc/1178-6973 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 223-228
language	English
source	In Infection and Drug Resistance (2018), Seite 223-228 year:2018 pages:223-228
sourceStr	In Infection and Drug Resistance (2018), Seite 223-228 year:2018 pages:223-228
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	amikacin elderly high-dose critical illness pharmacokinetics therapeutic drug monitoring Infectious and parasitic diseases
isfreeaccess_bool	true
container_title	Infection and Drug Resistance
authorswithroles_txt_mv	Sadeghi K @@aut@@ Hamishehkar H @@aut@@ Najmeddin F @@aut@@ Ahmadi A @@aut@@ Hazrati E @@aut@@ Honarmand H @@aut@@ Mojtahedzadeh M @@aut@@
publishDateDaySort_date	2018-01-01T00:00:00Z
hierarchy_top_id	600305996
id	DOAJ034118047
language_de	englisch
fullrecord	<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">DOAJ034118047</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230307184606.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230227s2018 xx \|\|\|\|\|o 00\| \|\|eng c</controlfield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)DOAJ034118047</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)DOAJ741443507a8b4c7aa3daf847b6c28b97</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="050" ind1=" " ind2="0"><subfield code="a">RC109-216</subfield></datafield><datafield tag="100" ind1="0" ind2=" "><subfield code="a">Sadeghi K</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">High-dose amikacin for achieving serum target levels in critically ill elderly patients</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2018</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 &micro;g/mL (P&lt;0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 &micro;g/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 &micro;g/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 &micro;g/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (&gt;64 &micro;g/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 &micro;g/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. 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callnumber-first	R - Medicine
author	Sadeghi K
spellingShingle	Sadeghi K misc RC109-216 misc amikacin misc elderly misc high-dose misc critical illness misc pharmacokinetics misc therapeutic drug monitoring misc Infectious and parasitic diseases High-dose amikacin for achieving serum target levels in critically ill elderly patients
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topic_title	RC109-216 High-dose amikacin for achieving serum target levels in critically ill elderly patients amikacin elderly high-dose critical illness pharmacokinetics therapeutic drug monitoring
topic	misc RC109-216 misc amikacin misc elderly misc high-dose misc critical illness misc pharmacokinetics misc therapeutic drug monitoring misc Infectious and parasitic diseases
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title	High-dose amikacin for achieving serum target levels in critically ill elderly patients
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title_full	High-dose amikacin for achieving serum target levels in critically ill elderly patients
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author_browse	Sadeghi K Hamishehkar H Najmeddin F Ahmadi A Hazrati E Honarmand H Mojtahedzadeh M
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title_sort	high-dose amikacin for achieving serum target levels in critically ill elderly patients
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title_auth	High-dose amikacin for achieving serum target levels in critically ill elderly patients
abstract	Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring
abstractGer	Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring
abstract_unstemmed	Kourosh Sadeghi,1 Hadi Hamishehkar,2 Farhad Najmeddin,1 Arezoo Ahmadi,3 Ebrahim Hazrati,4 Hooshyar Honarmand,1 Mojtaba Mojtahedzadeh1,5 1Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Clinical Pharmacy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3Department of Anesthesia and Intensive Care, Sina Hospital, Tehran University of Medical Science, Tehran, Iran; 4Department of Anesthesia and Intensive Care, Imam Reza Hospital, Army University of Medical Sciences, Tehran, Iran; 5Pharmaceutical Sciences Research Center, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Introduction: 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. Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 µg/mL (P<0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 µg/mL, respectively (P=0.035). On Day 7, the Cmax levels in the standard and high-dose groups were 33+-7.3 and 60.0+-17.6 µg/mL (P=0.001), and the Cmin levels were 3.2+-2.9 and 9.3+-5.6 µg/mL, respectively (P=0.002). In only six (40%) of the patients in the high-dose groups and none of the patients in the standard-dose group, amikacin Cmax reached the target levels (>64 µg/mL), whereas the amikacin mean Cmin levels in the high-dose group were above the threshold of toxicity (5 µg/mL). Conclusion: Our results suggest that the optimum dose of amikacin should be determined for elderly critically ill patients. It seems that higher-than-standard doses of amikacin with more extended intervals might be more appropriate than standard once-daily dosing in the elderly critically ill patients. Keywords: amikacin, elderly, high-dose, critical illness, pharmacokinetics, therapeutic drug monitoring
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title_short	High-dose amikacin for achieving serum target levels in critically ill elderly patients
url	https://doaj.org/article/741443507a8b4c7aa3daf847b6c28b97 https://www.dovepress.com/high-dose-amikacin-for-achieving-serum-target-levels-in-critically-ill-peer-reviewed-article-IDR https://doaj.org/toc/1178-6973
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Patients and methods: 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. Results: Data from 18 patients in Group A and 15 patients in Group B were finally analyzed. On Day 3, the amikacin mean Cmax levels in the standard and high-dose treatment groups were 30.4+-11 and 52.3+-16.1 &micro;g/mL (P&lt;0.001), and the Cmin levels were 3.2+-2.1 and 5.2+-2.8 &micro;g/mL, respectively (P=0.035). 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High-dose amikacin for achieving serum target levels in critically ill elderly patients

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