Amikacin is the
antibiotic of choice for the treatment of Gram-negative
infections, namely, those in neutropenic oncology patients. No populational pharmacokinetic studies are currently available reporting
amikacin pharmacokinetics in neutropenic oncology patients despite their specific pathophysiological features and treatments. A large-scale retrospective study was herein conducted to specifically investigate the effects that
tumor diseases have on the pharmacokinetic parameters of
amikacin and identify whether
chemotherapy, the lag time between administration of
chemotherapy and
amikacin, age and renal function contribute to
amikacin pharmacokinetics in neutropenic
cancer patients. A total of 1180 pharmacokinetic analysis from 629 neutropenic patients were enrolled. The daily dose administered to oncology patients was higher than that administered to non-oncology patients (p < 0.0001). No statistical differences were found in
amikacin concentrations, probably because drug clearance was increased in
cancer patients (p < 0.0001).
Chemotherapy influenced
amikacin pharmacokinetics and drug clearance decreased as the lag time enhanced. The elderly group revealed no statistical differences between the doses administered to both the oncology groups, suggesting that the impact of ageing is stronger than
chemotherapy. Our research suggests that
cancer patients require higher initial doses of
amikacin, as well as when
chemotherapy is received less than 30 days before
amikacin treatment has started.