Effect of Kidney Function on Amikacin Pharmacokinetics on Hospitalized Patients: Knowledge to Improve Therapy. Bioequiv & Bioavailab Int J 2017, 1(2): 000107

Despite the narrow therapeutic window characteristic of amikacin, this amino glycoside remains one of the most frequently prescribed particularly against multiple drug-resistant pathogens. In order to achieve an effective antibiotic therapeutic effect with minimal toxicity and, simultaneously avoid bacterial resistance development, the pharmacokinetics drug monitoring is recommended for amikacin. Since amikacin is almost 100% eliminated by glomerular filtration and it is nephroand ototoxic, its exposure and availability in renal patients is expected to be altered in relation to patients with normal organ function. In this context, the present study aimed at assessing the correlation between demographical/biochemical data and the pharmacokinetic parameters of amikacin in an attempt of developing dosage recommendations to renal patients. The present retrospective study included 628 patients undergoing therapy with amikacin and admitted in Coimbra University Hospital pole of the Hospital and University Centre of Coimbra, EPE, in Portugal, between 2008 and 2015. Blood samples were collected 1 h after the end of amikacin infusion and 30 min before the following administration to attain the peak concentration (Cmax) and the trough concentration (Cmin). Demographic data, dose and frequency of administration of amikacin and creatinemia were also collected for each patient, whose pharmacokinetic parameters were then calculated using equations Sawchuk and Zaske. The population was divided regarding the age of each patient (18-34; 35-49; 50-64; 65-79 and ≥80 years old) and regarding the glomerular filtration rate: <60, 60120 and ≥120 mL/min/1.73m. After checking the normality and homogeneity of variances test, ANOVA was used to determine statistical differences among those distinct sub-populations. Statistically significant differences were found between the 5 age groups Research Article