Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikaci...
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Gespeichert in:

Autor*in:	Gestina Aliska [verfasserIn] Rianto Setiabudi [verfasserIn] purwantyastuti purwantyastuti [verfasserIn] Anis Karuniawati [verfasserIn] Rudyanto Sedono [verfasserIn] Trisni U Dewi [verfasserIn] Muhammad K Azwar [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Schlagwörter:	amikacin aminoglycoside sepsis ICU MIC

Übergeordnetes Werk:	In: Acta Medica Indonesiana - Interna Publishing, 2013, 49(2017), 3
Übergeordnetes Werk:	volume:49 ; year:2017 ; number:3

Links:	Link aufrufen Link aufrufen Journal toc Journal toc

Katalog-ID:	DOAJ066535115

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520			\|a Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management.
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allfields	(DE-627)DOAJ066535115 (DE-599)DOAJe5c375765375497eb90347201834d5ee DE-627 ger DE-627 rakwb eng RC31-1245 Gestina Aliska verfasserin aut Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management. amikacin aminoglycoside sepsis ICU MIC Internal medicine Rianto Setiabudi verfasserin aut purwantyastuti purwantyastuti verfasserin aut Anis Karuniawati verfasserin aut Rudyanto Sedono verfasserin aut Trisni U Dewi verfasserin aut Muhammad K Azwar verfasserin aut In Acta Medica Indonesiana Interna Publishing, 2013 49(2017), 3 (DE-627)616382111 (DE-600)2531763-5 23382732 nnns volume:49 year:2017 number:3 https://doaj.org/article/e5c375765375497eb90347201834d5ee kostenfrei http://actamedindones.org/index.php/ijim/article/view/179 kostenfrei https://doaj.org/toc/0125-9326 Journal toc kostenfrei https://doaj.org/toc/2338-2732 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ 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_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 49 2017 3
spelling	(DE-627)DOAJ066535115 (DE-599)DOAJe5c375765375497eb90347201834d5ee DE-627 ger DE-627 rakwb eng RC31-1245 Gestina Aliska verfasserin aut Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management. amikacin aminoglycoside sepsis ICU MIC Internal medicine Rianto Setiabudi verfasserin aut purwantyastuti purwantyastuti verfasserin aut Anis Karuniawati verfasserin aut Rudyanto Sedono verfasserin aut Trisni U Dewi verfasserin aut Muhammad K Azwar verfasserin aut In Acta Medica Indonesiana Interna Publishing, 2013 49(2017), 3 (DE-627)616382111 (DE-600)2531763-5 23382732 nnns volume:49 year:2017 number:3 https://doaj.org/article/e5c375765375497eb90347201834d5ee kostenfrei http://actamedindones.org/index.php/ijim/article/view/179 kostenfrei https://doaj.org/toc/0125-9326 Journal toc kostenfrei https://doaj.org/toc/2338-2732 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ 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_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 49 2017 3
allfields_unstemmed	(DE-627)DOAJ066535115 (DE-599)DOAJe5c375765375497eb90347201834d5ee DE-627 ger DE-627 rakwb eng RC31-1245 Gestina Aliska verfasserin aut Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management. amikacin aminoglycoside sepsis ICU MIC Internal medicine Rianto Setiabudi verfasserin aut purwantyastuti purwantyastuti verfasserin aut Anis Karuniawati verfasserin aut Rudyanto Sedono verfasserin aut Trisni U Dewi verfasserin aut Muhammad K Azwar verfasserin aut In Acta Medica Indonesiana Interna Publishing, 2013 49(2017), 3 (DE-627)616382111 (DE-600)2531763-5 23382732 nnns volume:49 year:2017 number:3 https://doaj.org/article/e5c375765375497eb90347201834d5ee kostenfrei http://actamedindones.org/index.php/ijim/article/view/179 kostenfrei https://doaj.org/toc/0125-9326 Journal toc kostenfrei https://doaj.org/toc/2338-2732 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ 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_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 49 2017 3
allfieldsGer	(DE-627)DOAJ066535115 (DE-599)DOAJe5c375765375497eb90347201834d5ee DE-627 ger DE-627 rakwb eng RC31-1245 Gestina Aliska verfasserin aut Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management. amikacin aminoglycoside sepsis ICU MIC Internal medicine Rianto Setiabudi verfasserin aut purwantyastuti purwantyastuti verfasserin aut Anis Karuniawati verfasserin aut Rudyanto Sedono verfasserin aut Trisni U Dewi verfasserin aut Muhammad K Azwar verfasserin aut In Acta Medica Indonesiana Interna Publishing, 2013 49(2017), 3 (DE-627)616382111 (DE-600)2531763-5 23382732 nnns volume:49 year:2017 number:3 https://doaj.org/article/e5c375765375497eb90347201834d5ee kostenfrei http://actamedindones.org/index.php/ijim/article/view/179 kostenfrei https://doaj.org/toc/0125-9326 Journal toc kostenfrei https://doaj.org/toc/2338-2732 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ 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_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 49 2017 3
allfieldsSound	(DE-627)DOAJ066535115 (DE-599)DOAJe5c375765375497eb90347201834d5ee DE-627 ger DE-627 rakwb eng RC31-1245 Gestina Aliska verfasserin aut Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management. amikacin aminoglycoside sepsis ICU MIC Internal medicine Rianto Setiabudi verfasserin aut purwantyastuti purwantyastuti verfasserin aut Anis Karuniawati verfasserin aut Rudyanto Sedono verfasserin aut Trisni U Dewi verfasserin aut Muhammad K Azwar verfasserin aut In Acta Medica Indonesiana Interna Publishing, 2013 49(2017), 3 (DE-627)616382111 (DE-600)2531763-5 23382732 nnns volume:49 year:2017 number:3 https://doaj.org/article/e5c375765375497eb90347201834d5ee kostenfrei http://actamedindones.org/index.php/ijim/article/view/179 kostenfrei https://doaj.org/toc/0125-9326 Journal toc kostenfrei https://doaj.org/toc/2338-2732 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ 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_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 49 2017 3
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Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. 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callnumber-first	R - Medicine
author	Gestina Aliska
spellingShingle	Gestina Aliska misc RC31-1245 misc amikacin misc aminoglycoside misc sepsis misc ICU misc MIC misc Internal medicine Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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topic_title	RC31-1245 Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia amikacin aminoglycoside sepsis ICU MIC
topic	misc RC31-1245 misc amikacin misc aminoglycoside misc sepsis misc ICU misc MIC misc Internal medicine
topic_unstemmed	misc RC31-1245 misc amikacin misc aminoglycoside misc sepsis misc ICU misc MIC misc Internal medicine
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title	Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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title_full	Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia
author_sort	Gestina Aliska
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title_sort	optimal amikacin levels for patients with sepsis in intensive care unit of cipto mangunkusumo hospital, jakarta, indonesia
callnumber	RC31-1245
title_auth	Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia
abstract	Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management.
abstractGer	Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management.
abstract_unstemmed	Background: Amikacin is one of the antibiotics of choice for sepsis and septic shock. Pharmacokinetic of amikacin can be influenced by septic condition with subsequent effect on its pharmacodynamic. At Cipto Mangunkusumo Hospital (RSCM), Jakarta, adult patients in the ICU were given standard amikacin dose of 1 g/day, however the achievement of optimal plasma level had never been evaluated. This study aimed to evaluate whether the optimal plasma level of amikacin was achieved with the use of standard dose in septic conditions. Methods: all septic patients admitted to the intensive care unit of a national tertiary hospital receiving standard dose of 1g/day IV amikacin during May-September 2015 were included in this study. Information of minimum inhibitory concentration MIC was obtained from microbial culture. Cmax of amikacin was measured 30 minutes after administration and optimal level was calculated. Optimal amikacin level was considered achieved when Cmax/MIC ratio <8. Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. This study suggests that measurement of Cmax and MIC are important to optimize septic patients management.
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title_short	Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia
url	https://doaj.org/article/e5c375765375497eb90347201834d5ee http://actamedindones.org/index.php/ijim/article/view/179 https://doaj.org/toc/0125-9326 https://doaj.org/toc/2338-2732
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up_date	2024-07-03T20:35:45.112Z
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Results: average Cmax achieved for all patients was 86.4 (43.5-238) µg/mL with 87% patients had Cmax of <64 µg/mL.MIC data were available for 7 of 23 patients. MICs for identified pathogens were 0.75 - <256 µg/mL (K. pneumonia), 0.75 - <256 µg/mL(A. baumanii), 1.5 - <256 µg/mL (P. aeruginosa)and 0.75 – 16 µg/mL(E. coli). Four out of seven patients achieved optimal amikacin level. Conclusion: despite high Cmax, only half of the patients achieved optimal amikacin level with highly variable Cmax. 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Optimal Amikacin Levels for Patients with Sepsis in Intensive Care Unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia

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