Bourguignon Laurent, Goutelle Sylvain, Gérard Cécile, Guillermet Anne, Burdin de Saint Martin Julie, Maire Pascal, Ducher Michel
Université de Lyon 1, Ecole Doctorale E2M2 Evolution, Ecosystèmes, Microbiologie, Modélisation, UMR 5558, Biométrie et Biologie Evolutive, Villeurbanne, France.
Therapie. 2009 Jan-Feb;64(1):47-53. doi: 10.2515/therapie/2009009. Epub 2009 May 26.
The use of amikacin is difficult because of its toxicity and its pharmacokinetic variability. This variability is almost ignored in adult standard dosage regimens since only the weight is used in the dose calculation. Our objective is to test if the pharmacokinetic of amikacin can be regarded as homogenous, and if the method for calculating the dose according to patients' weight is appropriate. From a cohort of 580 patients, five groups of patients were created by statistical data partitioning. A population pharmacokinetic analysis was performed in each group. The adult population is not homogeneous in term of pharmacokinetics. The doses required to achieve a maximum concentration of 60 mg/L are strongly different (585 to 1507 mg) between groups. The exclusive use of the weight to calculate the dose of amikacine appears inappropriate for 80% of the patients, showing the limits of the formulae for calculating doses of aminoglycosides.
由于丁胺卡那霉素的毒性及其药代动力学变异性，其使用存在困难。在成人标准给药方案中，这种变异性几乎被忽略，因为剂量计算仅基于体重。我们的目的是检验丁胺卡那霉素的药代动力学是否可被视为同质，以及根据患者体重计算剂量的方法是否合适。通过统计数据划分，从580名患者队列中创建了五组患者。对每组患者进行群体药代动力学分析。就药代动力学而言，成人总体并非同质。各组之间达到60mg/L最大浓度所需的剂量差异很大（585至1507mg）。对于80%的患者，仅用体重来计算丁胺卡那霉素的剂量似乎不合适，这表明了氨基糖苷类药物剂量计算公式的局限性。
