[Clinical, pharmacokinetic and therapeutic study of amikacin with single daily dose and in combination in neutropenic children with fever].

Abstract

BACKGROUND:

The efficacy of single daily dose of amikacin has been recently demonstrated in neutropenic children with fever.

POPULATION AND METHODS:

Eighteen children aged 1 to 15 years were included in the study. All patients were febrile and granulocytopenic and had indwelling intravenous catheter. Amikacin was administered as a 30-minute intravenous infusion once daily (20 mg/kg on day 1, then 15 mg/kg) for 3 to 30 days; the patients received amikacin in combination with piperacillin and vancomycin. Serum levels of amikacin were measured on days 1, 3, 6 and 10, and 30 min, 60 min and 180 min after the end of the infusion.

RESULTS:

All patients responded favourably to the antibiotic therapy. Sixty-two kinetics were performed: peak amikacin concentrations measured (30 min after 30-min infusion) on day 1 averaged 43.7 micrograms/mL (+/- 13.8). A significant increase in peak serum concentrations was observed during the treatment (day 3 vs day 10) without change in the trough serum concentrations. The volumes of distribution were considerably important in these granulocytopenic children and there was a large inter and intra-patient variability; the elimination half-life of the amikacin was short (1.45 h). There was no significant nephrotoxicity in any patient.

CONCLUSION:

The use of single daily dose amikacin in combination with a broad spectrum beta-lactam antibiotic and vancomycin was efficient and safe in febrile granulocytopenic children. The simulation of the amikacin behaviour in the deep compartment should be evaluated; in fact, it might reflect better accumulation of the drug than serum concentrations.

• Authors: Y Bertrand, V Bréant, C Vray, C Nakache, G Barbé, F Dürr, G Aulagner
• Journal: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie (Arch Pediatr) Vol. 3 Issue 9 Pg. 854-60 (Sep 1996) ISSN: 0929-693X [Print] France
• Vernacular Title: Etude clinique, pharmacocinétique et thérapeutique de l'amikacine en dose unique journalière et en association chez l'enfant neutropénique fébrile.
• PMID: 8949344 (Publication Type: English Abstract, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Penicillins
• Vancomycin
• Amikacin
• Piperacillin

Topics

• Adolescent
• Amikacin (administration & dosage, blood, pharmacokinetics, therapeutic use)
• Anti-Bacterial Agents (administration & dosage, blood, pharmacokinetics, therapeutic use)
• Child
• Child, Preschool
• Drug Therapy, Combination
• Fever (complications)
• Humans
• Infant
• Neutropenia (complications, drug therapy)
• Penicillins (administration & dosage, therapeutic use)
• Piperacillin (administration & dosage, therapeutic use)
• Vancomycin (administration & dosage, therapeutic use)