Once-daily dosing of amikacin for treatment of Mycobacterium abscessus lung disease
Authors
Lee, H. ; Sohn, Y. M. ; Ko, J. Y. ; Lee, S-Y. ; Jhun, B. W. ; Park, H. Y. ; Jeon, K. ; Kim, D. H. ; Kim, S-Y. ; Choi, J. E. ; Moon, I. J. ; Shin, S. J. ; Park, H. J. ; Koh, W-J.
Citation
INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol.21(7) : 818-824, 2017
SETTING: Tertiary referral centre, Samsung Medical Center, South Korea.
OBJECTIVE: To evaluate the pharmacokinetic parameters and toxicities of once-daily amikacin (AMK) dosing for lung disease due to Mycobacterium abscessus.
DESIGN: A retrospective review of 48 patients with M. abscessus lung disease who received once-daily AMK for 4 weeks between January 2012 and June 2015.
RESULTS: With a starting dose of 15 mg/kg/day and adjustment of AMK dose according to the peak serum level (Cmax), the Cmax target of 55-65 μg/ml was achieved in 31.3% (15/48) of patients in the first week, 68.8% (33/48) in week 2, 91.7% (44/48) in week 3 and 95.8% (46/48) in week 4. Transient nephrotoxicity developed in 6.3% (3/48) of patients and ototoxicity in 25.0% (6/24), which was determined by audiogram as hearing loss, asymptomatic in five patients and tinnitus in one. Multivariate analysis revealed that the highest drug concentration 12 h after administration was significantly associated with the development of toxicities (adjusted odds ratio 1.862, P = 0.047).
CONCLUSION: Our results suggest that once-daily AMK for 4 weeks with a target Cmax of 55-65 μg/ml can be used in patients with M. abscessus lung disease, with careful monitoring of toxicity.