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

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Summary

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 (μg/ml) and trough concentration (μg/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) μg/ml; 0.85 (0.74) and 0.18 (0.24) μg/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.

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Authors and Affiliations

  1. Clinical Pharmacology Unit B, Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Rambam Medical Center, P. O. Box 9602, 31096, Haifa, Israel

    N. Krivoy M.D.

  2. Pediatric Hemato-Oncology Unit, B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Rambam Medical Center, P. O. Box 9602, 31096, Haifa, Israel

    S. Postovsky M.D., R. Elhasid M.D. & M. Weyl Ben Arush M.D.

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  1. N. Krivoy M.D.
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  2. S. Postovsky M.D.
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  3. R. Elhasid M.D.
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  4. M. Weyl Ben Arush M.D.
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Krivoy, N., Postovsky, S., Elhasid, R. et al. Pharmacokinetic analysis of amikacin twice and single daily dosage in immunocompromised pediatric patients. Infection 26, 396–398 (1998). https://doi.org/10.1007/BF02770843

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  • DOI: https://doi.org/10.1007/BF02770843

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