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Adv Pharm Bull. 2020;10(1): 114-118.
doi: 10.15171/apb.2020.014
  Abstract View: 68
  PDF Download: 73

Research Article

Evaluation of Amikacin Pharmacokinetics in Critically Ill Patients with Intra-abdominal Sepsis

Bita Shahrami 1 ORCID logo, Farhad Najmeddin 1 ORCID logo, Mohammad Reza Rouini 2 ORCID logo, Atabak Najafi 3 ORCID logo, Kourosh Sadeghi 1 ORCID logo, Shahideh Amini 1 ORCID logo, Seyedeh Sana Khezrnia 4 ORCID logo, Hamid Reza Sharifnia 3 ORCID logo, Mojtaba Mojtahedzadeh 1 * ORCID logo

1 Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
2 Department of Pharmaceutics, Tehran University of Medical Sciences, Tehran, Iran.
3 Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran.
4 School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Purpose: Although the current widespread use of amikacin is in intra-abdominal sepsis treatment, its pharmacokinetic changes in the present setting are not yet well known. This study was aimed to evaluate the amikacin pharmacokinetic profile in critically ill patients with intraabdominal sepsis compared to pneumosepsis.

Methods: Adult septic patients received amikacin therapy were studied. Patients with intraabdominal sepsis were enrolled in group 1 (n=16), and patients with pneumosepsis were enrolled in group 2 (n=13). The amikacin serum concentrations were evaluated in the first, second, fourth and sixth hours after initiating 30-minute infusion. The pharmacokinetic parameters were calculated for each patient.

Results: There was no significant difference in the volume of distribution between the two groups (0.33±0.08 vs. 0.28±0.10 L/kg, P=0.193). The amikacin clearance was significantly lower in group 1 compared to group 2 (58.5±21.7 vs. 83.9±37.0 mL/min, P=0.029). There was no significant correlation between amikacin clearance and creatinine clearance estimated by Cockcroft-Gault formula in all patients (P=0.206). The half-life was significantly longer in group 1 compared to group 2 (5.3±2.8 vs. 3.4±3.2 hours, P=0.015).

Conclusion: Pathophysiologic changes following intra-abdominal sepsis can affect amikacin pharmacokinetics behavior. The clearance and half-life may change, but the alteration of the volume of distribution is not significantly different in comparison with pneumosepsis. Further studies are required to evaluate the pharmacokinetic variables of amikacin in critically ill patients with intra-abdominal sepsis.

Keywords: Amikacin, Aminoglycoside, Critical Illness, Intra-abdominal Infection, Pharmacokinetics, Sepsis
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Submitted: 25 Jul 2019
Revision: 07 Sep 2019
Accepted: 18 Sep 2019
ePublished: 11 Dec 2019
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