NECESSITY OF INCREASED DOSES OF AMIKACIN IN BURN PATIENTS

  • 1 January 1978
    • journal article
    • research article
    • Vol. 84  (5) , 603-608
Abstract
Extended periods (6-9 h) of subtherapeutic serum amikacin levels were observed in 5 burn patients receiving the recommended i.v. dose of 7.5 mg/kg every 12 h. Kinetic studies revealed an unusually short half-life, especially in younger patients. This more rapid elimination necessitated a shorter dosing interval (every 6 h), resulting in an increased daily dose (30 mg/kg per day). In this study of 10 patients with normal renal function, an i.v. dosage regimen of 7.5 mg/kg every 6 h resulted in therapeutic peak concentrations and shortened intervals of subtherapeutic serum concentrations. A transient episode of tinnitus without cochlear damage occurred in 1 patient after the first dose. Neither ototoxicity nor nephrotoxicity occurred in any of the patients. Because of interpatient variability in amikacin elimination, frequent monitoring of serum levels with necessary dosage changes it is imperative to provide optimal serum concentrations. It must be emphasized that these increased dosage regimens of amikacin are not suggested for routine use without previously measuring serum levels.

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