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Once-daily dosing of amikacin for treatment of Mycobacterium abscessus lung disease

 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. 
 International Journal of Tuberculosis and Lung Disease, Vol.21(7) : 818-824, 2017 
Journal Title
 International Journal of Tuberculosis and Lung Disease 
Issue Date
Aged ; Amikacin/administration & dosage* ; Amikacin/adverse effects ; Amikacin/pharmacokinetics ; Anti-Bacterial Agents/administration & dosage* ; Anti-Bacterial Agents/adverse effects ; Anti-Bacterial Agents/pharmacokinetics ; Drug Administration Schedule ; Drug Monitoring/methods ; Female ; Hearing Loss/chemically induced ; Hearing Loss/epidemiology ; Humans ; Kidney Diseases/chemically induced ; Kidney Diseases/epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Mycobacterium Infections, Nontuberculous/drug therapy* ; Mycobacterium Infections, Nontuberculous/microbiology ; Mycobacterium abscessus/isolation & purification* ; Republic of Korea ; Retrospective Studies ; Tinnitus/chemically induced ; Tinnitus/epidemiology
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.
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1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실) > 1. Journal Papers
Yonsei Authors
신성재(Shin, Sung Jae) ORCID logo https://orcid.org/0000-0003-0854-4582
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