Standard dosing of amikacin and gentamicin in critically ill patients results in variable and subtherapeutic concentrations.
Identifieur interne : 002651 ( PubMed/Checkpoint ); précédent : 002650; suivant : 002652Standard dosing of amikacin and gentamicin in critically ill patients results in variable and subtherapeutic concentrations.
Auteurs : Claire Roger [France] ; Bastian Nucci [France] ; Nicolas Molinari [France] ; Sophie Bastide [France] ; Gilbert Saissi [France] ; Gael Pradel [France] ; Saber Barbar [France] ; Clément Aubert [France] ; Sophie Lloret [France] ; Loubna Elotmani [France] ; Anne Polge [France] ; Jean-Yves Lefrant [France] ; Jason A. Roberts [Australie] ; Laurent Muller [France]Source :
- International journal of antimicrobial agents [ 1872-7913 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Amikacine (administration et posologie), Amikacine (pharmacocinétique), Antibactériens (administration et posologie), Antibactériens (pharmacocinétique), Femelle, Gentamicine (administration et posologie), Gentamicine (pharmacocinétique), Humains, Infections bactériennes (traitement médicamenteux), Infections intra-abdominales (traitement médicamenteux), Infections urinaires (traitement médicamenteux), Maladie grave, Mâle, Plasma sanguin (), Pneumopathie bactérienne (traitement médicamenteux), Sujet âgé, Sujet âgé de 80 ans ou plus, Études de cohortes.
- MESH :
- administration et posologie : Amikacine, Antibactériens, Gentamicine.
- pharmacocinétique : Amikacine, Antibactériens, Gentamicine.
- traitement médicamenteux : Infections bactériennes, Infections intra-abdominales, Infections urinaires, Pneumopathie bactérienne.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Maladie grave, Mâle, Plasma sanguin, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de cohortes.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Amikacin (administration & dosage), Amikacin (pharmacokinetics), Anti-Bacterial Agents (administration & dosage), Anti-Bacterial Agents (pharmacokinetics), Bacterial Infections (drug therapy), Cohort Studies, Critical Illness, Female, Gentamicins (administration & dosage), Gentamicins (pharmacokinetics), Humans, Intraabdominal Infections (drug therapy), Male, Middle Aged, Plasma (chemistry), Pneumonia, Bacterial (drug therapy), Urinary Tract Infections (drug therapy).
- MESH :
- chemical , administration & dosage : Amikacin, Anti-Bacterial Agents, Gentamicins.
- chemical , pharmacokinetics : Amikacin, Anti-Bacterial Agents, Gentamicins.
- chemistry : Plasma.
- drug therapy : Bacterial Infections, Intraabdominal Infections, Pneumonia, Bacterial, Urinary Tract Infections.
- Adult, Aged, Aged, 80 and over, Cohort Studies, Critical Illness, Female, Humans, Male, Middle Aged.
Abstract
Low peak plasma concentrations (Cmax) of amikacin and gentamicin are reported in intensive care unit (ICU) patients after administration of the first dose. The present study aimed to describe the proportion of ICU patients in whom an adequate Cmax was achieved throughout the course of therapy. Septic ICU patients with an indication for intravenous amikacin or gentamicin were eligible for inclusion in this single-centre observational study. The first and subsequent doses and the corresponding Cmax values were recorded. The target Cmax was ≥60mg/L for amikacin and ≥30mg/L for gentamicin. Amikacin and gentamicin plasma concentrations were available in 66 and 24 patients, respectively (59±17 years; 79±19kg; height 169±12cm; SAPS II score 46±19). Pulmonary, abdominal and urinary tract infections were diagnosed in 64 patients. Culture-positive infection was confirmed in 65 patients (72%). A target first Cmax was achieved in 17/90 patients (19%). For amikacin, the target Cmax was achieved in 16/66 patients (24%) after the initial dose. In the 50 remaining patients, a change in dosing was performed in 14 patients, leading adequate peak plasma level in 2 patients. For gentamicin, the targeted Cmax was achieved in only 1/24 patient (4%) after the initial dose and was never achieved after the third dose. In conclusion, standard dosing of amikacin or gentamicin led to adequate Cmax in only 19% of patients. Subtherapeutic Cmax were not significantly corrected after subsequent doses.
DOI: 10.1016/j.ijantimicag.2015.02.009
PubMed: 25857948
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Service de Réanimation, CH Avignon, 84 000 Avignon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; Service de Réanimation, CH Avignon, 84 000 Avignon</wicri:regionArea><wicri:noRegion>84 000 Avignon</wicri:noRegion><wicri:noRegion>84 000 Avignon</wicri:noRegion></affiliation></author><author><name sortKey="Barbar, Saber" sort="Barbar, Saber" uniqKey="Barbar S" first="Saber" last="Barbar">Saber Barbar</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Aubert, Clement" sort="Aubert, Clement" uniqKey="Aubert C" first="Clément" last="Aubert">Clément Aubert</name><affiliation wicri:level="1"><nlm:affiliation>Service de Pharmacie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Pharmacie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Lloret, Sophie" sort="Lloret, Sophie" uniqKey="Lloret S" first="Sophie" last="Lloret">Sophie Lloret</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Elotmani, Loubna" sort="Elotmani, Loubna" uniqKey="Elotmani L" first="Loubna" last="Elotmani">Loubna Elotmani</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Polge, Anne" sort="Polge, Anne" uniqKey="Polge A" first="Anne" last="Polge">Anne Polge</name><affiliation wicri:level="1"><nlm:affiliation>Laboratoire de Biochimie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire de Biochimie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Lefrant, Jean Yves" sort="Lefrant, Jean Yves" uniqKey="Lefrant J" first="Jean-Yves" last="Lefrant">Jean-Yves Lefrant</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes, France. Electronic address: jean-yves.lefrant@wanadoo.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes</wicri:regionArea><wicri:noRegion>30 000 Nîmes</wicri:noRegion><wicri:noRegion>30 000 Nîmes</wicri:noRegion></affiliation></author><author><name sortKey="Roberts, Jason A" sort="Roberts, Jason A" uniqKey="Roberts J" first="Jason A" last="Roberts">Jason A. Roberts</name><affiliation wicri:level="1"><nlm:affiliation>Burns, Trauma and Critical Care Research Centre, The University of Queensland, Royal Brisbane and Women's Hospital, Herston, Brisbane 4029, QLD, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Burns, Trauma and Critical Care Research Centre, The University of Queensland, Royal Brisbane and Women's Hospital, Herston, Brisbane 4029, QLD</wicri:regionArea><wicri:noRegion>QLD</wicri:noRegion></affiliation></author><author><name sortKey="Muller, Laurent" sort="Muller, Laurent" uniqKey="Muller L" first="Laurent" last="Muller">Laurent Muller</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes</wicri:regionArea><wicri:noRegion>30 000 Nîmes</wicri:noRegion><wicri:noRegion>30 000 Nîmes</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2015">2015</date><idno type="RBID">pubmed:25857948</idno><idno type="pmid">25857948</idno><idno type="doi">10.1016/j.ijantimicag.2015.02.009</idno><idno type="wicri:Area/PubMed/Corpus">002C26</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002C26</idno><idno type="wicri:Area/PubMed/Curation">002B53</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002B53</idno><idno type="wicri:Area/PubMed/Checkpoint">002B53</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">002B53</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Standard dosing of amikacin and gentamicin in critically ill patients results in variable and subtherapeutic concentrations.</title><author><name sortKey="Roger, Claire" sort="Roger, Claire" uniqKey="Roger C" first="Claire" last="Roger">Claire Roger</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes</wicri:regionArea><wicri:noRegion>30 000 Nîmes</wicri:noRegion><wicri:noRegion>30 000 Nîmes</wicri:noRegion></affiliation></author><author><name sortKey="Nucci, Bastian" sort="Nucci, Bastian" uniqKey="Nucci B" first="Bastian" last="Nucci">Bastian Nucci</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Molinari, Nicolas" sort="Molinari, Nicolas" uniqKey="Molinari N" first="Nicolas" last="Molinari">Nicolas Molinari</name><affiliation wicri:level="1"><nlm:affiliation>Department of Biostatistics, UMR 729 MISTEA, Montpellier University Hospital, Avenue Gaston Giraud, Montpellier 34093, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Biostatistics, UMR 729 MISTEA, Montpellier University Hospital, Avenue Gaston Giraud, Montpellier 34093</wicri:regionArea><wicri:noRegion>34093</wicri:noRegion><placeName><settlement type="city">Montpellier</settlement><region type="region" nuts="2">Occitanie (région administrative)</region><region type="old region" nuts="2">Languedoc-Roussillon</region></placeName></affiliation></author><author><name sortKey="Bastide, Sophie" sort="Bastide, Sophie" uniqKey="Bastide S" first="Sophie" last="Bastide">Sophie Bastide</name><affiliation wicri:level="1"><nlm:affiliation>Service Biostatistique Epidémiologie, Santé Publique Information Médicale, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service Biostatistique Epidémiologie, Santé Publique Information Médicale, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Saissi, Gilbert" sort="Saissi, Gilbert" uniqKey="Saissi G" first="Gilbert" last="Saissi">Gilbert Saissi</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Pradel, Gael" sort="Pradel, Gael" uniqKey="Pradel G" first="Gael" last="Pradel">Gael Pradel</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; Service de Réanimation, CH Avignon, 84 000 Avignon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; Service de Réanimation, CH Avignon, 84 000 Avignon</wicri:regionArea><wicri:noRegion>84 000 Avignon</wicri:noRegion><wicri:noRegion>84 000 Avignon</wicri:noRegion></affiliation></author><author><name sortKey="Barbar, Saber" sort="Barbar, Saber" uniqKey="Barbar S" first="Saber" last="Barbar">Saber Barbar</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Aubert, Clement" sort="Aubert, Clement" uniqKey="Aubert C" first="Clément" last="Aubert">Clément Aubert</name><affiliation wicri:level="1"><nlm:affiliation>Service de Pharmacie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Pharmacie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Lloret, Sophie" sort="Lloret, Sophie" uniqKey="Lloret S" first="Sophie" last="Lloret">Sophie Lloret</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Elotmani, Loubna" sort="Elotmani, Loubna" uniqKey="Elotmani L" first="Loubna" last="Elotmani">Loubna Elotmani</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Polge, Anne" sort="Polge, Anne" uniqKey="Polge A" first="Anne" last="Polge">Anne Polge</name><affiliation wicri:level="1"><nlm:affiliation>Laboratoire de Biochimie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire de Biochimie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9</wicri:regionArea><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion><wicri:noRegion>30 029 Nîmes Cedex 9</wicri:noRegion></affiliation></author><author><name sortKey="Lefrant, Jean Yves" sort="Lefrant, Jean Yves" uniqKey="Lefrant J" first="Jean-Yves" last="Lefrant">Jean-Yves Lefrant</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes, France. Electronic address: jean-yves.lefrant@wanadoo.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes</wicri:regionArea><wicri:noRegion>30 000 Nîmes</wicri:noRegion><wicri:noRegion>30 000 Nîmes</wicri:noRegion></affiliation></author><author><name sortKey="Roberts, Jason A" sort="Roberts, Jason A" uniqKey="Roberts J" first="Jason A" last="Roberts">Jason A. Roberts</name><affiliation wicri:level="1"><nlm:affiliation>Burns, Trauma and Critical Care Research Centre, The University of Queensland, Royal Brisbane and Women's Hospital, Herston, Brisbane 4029, QLD, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Burns, Trauma and Critical Care Research Centre, The University of Queensland, Royal Brisbane and Women's Hospital, Herston, Brisbane 4029, QLD</wicri:regionArea><wicri:noRegion>QLD</wicri:noRegion></affiliation></author><author><name sortKey="Muller, Laurent" sort="Muller, Laurent" uniqKey="Muller L" first="Laurent" last="Muller">Laurent Muller</name><affiliation wicri:level="1"><nlm:affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes</wicri:regionArea><wicri:noRegion>30 000 Nîmes</wicri:noRegion><wicri:noRegion>30 000 Nîmes</wicri:noRegion></affiliation></author></analytic><series><title level="j">International journal of antimicrobial agents</title><idno type="eISSN">1872-7913</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Amikacin (administration & dosage)</term><term>Amikacin (pharmacokinetics)</term><term>Anti-Bacterial Agents (administration & dosage)</term><term>Anti-Bacterial Agents (pharmacokinetics)</term><term>Bacterial Infections (drug therapy)</term><term>Cohort Studies</term><term>Critical Illness</term><term>Female</term><term>Gentamicins (administration & dosage)</term><term>Gentamicins (pharmacokinetics)</term><term>Humans</term><term>Intraabdominal Infections (drug therapy)</term><term>Male</term><term>Middle Aged</term><term>Plasma (chemistry)</term><term>Pneumonia, Bacterial (drug therapy)</term><term>Urinary Tract Infections (drug therapy)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Amikacine (administration et posologie)</term><term>Amikacine (pharmacocinétique)</term><term>Antibactériens (administration et posologie)</term><term>Antibactériens (pharmacocinétique)</term><term>Femelle</term><term>Gentamicine (administration et posologie)</term><term>Gentamicine (pharmacocinétique)</term><term>Humains</term><term>Infections bactériennes (traitement médicamenteux)</term><term>Infections intra-abdominales (traitement médicamenteux)</term><term>Infections urinaires (traitement médicamenteux)</term><term>Maladie grave</term><term>Mâle</term><term>Plasma sanguin ()</term><term>Pneumopathie bactérienne (traitement médicamenteux)</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études de cohortes</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Amikacin</term><term>Anti-Bacterial Agents</term><term>Gentamicins</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacokinetics" xml:lang="en"><term>Amikacin</term><term>Anti-Bacterial Agents</term><term>Gentamicins</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Amikacine</term><term>Antibactériens</term><term>Gentamicine</term></keywords><keywords scheme="MESH" qualifier="chemistry" xml:lang="en"><term>Plasma</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Bacterial Infections</term><term>Intraabdominal Infections</term><term>Pneumonia, Bacterial</term><term>Urinary Tract Infections</term></keywords><keywords scheme="MESH" qualifier="pharmacocinétique" xml:lang="fr"><term>Amikacine</term><term>Antibactériens</term><term>Gentamicine</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections bactériennes</term><term>Infections intra-abdominales</term><term>Infections urinaires</term><term>Pneumopathie bactérienne</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Critical Illness</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Maladie grave</term><term>Mâle</term><term>Plasma sanguin</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études de cohortes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Low peak plasma concentrations (Cmax) of amikacin and gentamicin are reported in intensive care unit (ICU) patients after administration of the first dose. The present study aimed to describe the proportion of ICU patients in whom an adequate Cmax was achieved throughout the course of therapy. Septic ICU patients with an indication for intravenous amikacin or gentamicin were eligible for inclusion in this single-centre observational study. The first and subsequent doses and the corresponding Cmax values were recorded. The target Cmax was ≥60mg/L for amikacin and ≥30mg/L for gentamicin. Amikacin and gentamicin plasma concentrations were available in 66 and 24 patients, respectively (59±17 years; 79±19kg; height 169±12cm; SAPS II score 46±19). Pulmonary, abdominal and urinary tract infections were diagnosed in 64 patients. Culture-positive infection was confirmed in 65 patients (72%). A target first Cmax was achieved in 17/90 patients (19%). For amikacin, the target Cmax was achieved in 16/66 patients (24%) after the initial dose. In the 50 remaining patients, a change in dosing was performed in 14 patients, leading adequate peak plasma level in 2 patients. For gentamicin, the targeted Cmax was achieved in only 1/24 patient (4%) after the initial dose and was never achieved after the third dose. In conclusion, standard dosing of amikacin or gentamicin led to adequate Cmax in only 19% of patients. Subtherapeutic Cmax were not significantly corrected after subsequent doses.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25857948</PMID><DateCreated><Year>2015</Year><Month>06</Month><Day>10</Day></DateCreated><DateCompleted><Year>2016</Year><Month>02</Month><Day>29</Day></DateCompleted><DateRevised><Year>2015</Year><Month>06</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1872-7913</ISSN><JournalIssue CitedMedium="Internet"><Volume>46</Volume><Issue>1</Issue><PubDate><Year>2015</Year><Month>Jul</Month></PubDate></JournalIssue><Title>International journal of antimicrobial agents</Title><ISOAbbreviation>Int. J. Antimicrob. Agents</ISOAbbreviation></Journal><ArticleTitle>Standard dosing of amikacin and gentamicin in critically ill patients results in variable and subtherapeutic concentrations.</ArticleTitle><Pagination><MedlinePgn>21-7</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijantimicag.2015.02.009</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0924-8579(15)00100-4</ELocationID><Abstract><AbstractText>Low peak plasma concentrations (Cmax) of amikacin and gentamicin are reported in intensive care unit (ICU) patients after administration of the first dose. The present study aimed to describe the proportion of ICU patients in whom an adequate Cmax was achieved throughout the course of therapy. Septic ICU patients with an indication for intravenous amikacin or gentamicin were eligible for inclusion in this single-centre observational study. The first and subsequent doses and the corresponding Cmax values were recorded. The target Cmax was ≥60mg/L for amikacin and ≥30mg/L for gentamicin. Amikacin and gentamicin plasma concentrations were available in 66 and 24 patients, respectively (59±17 years; 79±19kg; height 169±12cm; SAPS II score 46±19). Pulmonary, abdominal and urinary tract infections were diagnosed in 64 patients. Culture-positive infection was confirmed in 65 patients (72%). A target first Cmax was achieved in 17/90 patients (19%). For amikacin, the target Cmax was achieved in 16/66 patients (24%) after the initial dose. In the 50 remaining patients, a change in dosing was performed in 14 patients, leading adequate peak plasma level in 2 patients. For gentamicin, the targeted Cmax was achieved in only 1/24 patient (4%) after the initial dose and was never achieved after the third dose. In conclusion, standard dosing of amikacin or gentamicin led to adequate Cmax in only 19% of patients. Subtherapeutic Cmax were not significantly corrected after subsequent doses.</AbstractText><CopyrightInformation>Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Roger</LastName><ForeName>Claire</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nucci</LastName><ForeName>Bastian</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Molinari</LastName><ForeName>Nicolas</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Department of Biostatistics, UMR 729 MISTEA, Montpellier University Hospital, Avenue Gaston Giraud, Montpellier 34093, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bastide</LastName><ForeName>Sophie</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Service Biostatistique Epidémiologie, Santé Publique Information Médicale, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Saissi</LastName><ForeName>Gilbert</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pradel</LastName><ForeName>Gael</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; Service de Réanimation, CH Avignon, 84 000 Avignon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barbar</LastName><ForeName>Saber</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aubert</LastName><ForeName>Clément</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service de Pharmacie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lloret</LastName><ForeName>Sophie</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Elotmani</LastName><ForeName>Loubna</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Polge</LastName><ForeName>Anne</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Laboratoire de Biochimie, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lefrant</LastName><ForeName>Jean-Yves</ForeName><Initials>JY</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes, France. Electronic address: jean-yves.lefrant@wanadoo.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roberts</LastName><ForeName>Jason A</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>Burns, Trauma and Critical Care Research Centre, The University of Queensland, Royal Brisbane and Women's Hospital, Herston, Brisbane 4029, QLD, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Muller</LastName><ForeName>Laurent</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Service des reanimations, Pôle Anesthésie Réanimation Douleur Urgence, CHU Nîmes, Place du Professeur Robert Debré, 30 029 Nîmes Cedex 9, France; EA 2992, Faculté de Médicine Montpellier Nîmes, Avenue JF Kennedy, 30 000 Nîmes, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>03</Month><Day>19</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Int J Antimicrob Agents</MedlineTA><NlmUniqueID>9111860</NlmUniqueID><ISSNLinking>0924-8579</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D005839">Gentamicins</NameOfSubstance></Chemical><Chemical><RegistryNumber>84319SGC3C</RegistryNumber><NameOfSubstance UI="D000583">Amikacin</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000583" MajorTopicYN="N">Amikacin</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000493" MajorTopicYN="Y">pharmacokinetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000493" MajorTopicYN="Y">pharmacokinetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001424" MajorTopicYN="N">Bacterial Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016638" MajorTopicYN="N">Critical Illness</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005839" MajorTopicYN="N">Gentamicins</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000493" MajorTopicYN="Y">pharmacokinetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D059413" MajorTopicYN="N">Intraabdominal Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010949" MajorTopicYN="N">Plasma</DescriptorName><QualifierName UI="Q000737" MajorTopicYN="Y">chemistry</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018410" MajorTopicYN="N">Pneumonia, Bacterial</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014552" MajorTopicYN="N">Urinary Tract Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Aminoglycoside</Keyword><Keyword MajorTopicYN="N">ICU</Keyword><Keyword MajorTopicYN="N">Peak plasma concentration</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>11</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2015</Year><Month>02</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>02</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>4</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>4</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>3</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25857948</ArticleId><ArticleId IdType="pii">S0924-8579(15)00100-4</ArticleId><ArticleId IdType="doi">10.1016/j.ijantimicag.2015.02.009</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li><li>France</li></country><region><li>Languedoc-Roussillon</li><li>Occitanie (région administrative)</li></region><settlement><li>Montpellier</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Roger, Claire" sort="Roger, Claire" uniqKey="Roger C" first="Claire" last="Roger">Claire Roger</name></noRegion><name sortKey="Aubert, Clement" sort="Aubert, Clement" uniqKey="Aubert C" first="Clément" last="Aubert">Clément Aubert</name><name sortKey="Barbar, Saber" sort="Barbar, Saber" uniqKey="Barbar S" first="Saber" last="Barbar">Saber Barbar</name><name sortKey="Bastide, Sophie" sort="Bastide, Sophie" uniqKey="Bastide S" first="Sophie" last="Bastide">Sophie Bastide</name><name sortKey="Elotmani, Loubna" sort="Elotmani, Loubna" uniqKey="Elotmani L" first="Loubna" last="Elotmani">Loubna Elotmani</name><name sortKey="Lefrant, Jean Yves" sort="Lefrant, Jean Yves" uniqKey="Lefrant J" first="Jean-Yves" last="Lefrant">Jean-Yves Lefrant</name><name sortKey="Lloret, Sophie" sort="Lloret, Sophie" uniqKey="Lloret S" first="Sophie" last="Lloret">Sophie Lloret</name><name sortKey="Molinari, Nicolas" sort="Molinari, Nicolas" uniqKey="Molinari N" first="Nicolas" last="Molinari">Nicolas Molinari</name><name sortKey="Muller, Laurent" sort="Muller, Laurent" uniqKey="Muller L" first="Laurent" last="Muller">Laurent Muller</name><name sortKey="Nucci, Bastian" sort="Nucci, Bastian" uniqKey="Nucci B" first="Bastian" last="Nucci">Bastian Nucci</name><name sortKey="Polge, Anne" sort="Polge, Anne" uniqKey="Polge A" first="Anne" last="Polge">Anne Polge</name><name sortKey="Pradel, Gael" sort="Pradel, Gael" uniqKey="Pradel G" first="Gael" last="Pradel">Gael Pradel</name><name sortKey="Saissi, Gilbert" sort="Saissi, Gilbert" uniqKey="Saissi G" first="Gilbert" last="Saissi">Gilbert Saissi</name></country><country name="Australie"><noRegion><name sortKey="Roberts, Jason A" sort="Roberts, Jason A" uniqKey="Roberts J" first="Jason A" last="Roberts">Jason A. 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