Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, The Islamic Republic of Iran.
School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.
Eur J Hosp Pharm. 2022 Mar;29(e1):e72-e76. doi: 10.1136/ejhpharm-2021-003089. Epub 2021 Nov 11.
This study aimed to evaluate the relationship between amikacin pharmacokinetics and the biomarkers associated with organ dysfunction in critically ill patients with intra-abdominal sepsis.
A case series involving critically ill patients with intra-abdominal sepsis who received an amikacin loading dose of 20-25 mg/kg intravenous infusion was studied. The 1-, 2-, 4-, 6- and 24-hour amikacin serum concentrations were measured to calculate the pharmacokinetic parameters. The Sequential Organ Failure Assessment (SOFA) score, white blood cells, neutrophil to lymphocyte ratio, platelet count, serum creatinine, creatinine clearance, bilirubin, partial pressure of oxygen to fraction of inspired oxygen ratio, serum albumin, procalcitonin, lactate level, erythrocyte sedimentation rate (ESR) and C-reactive protein were recorded. A linear regression analysis was performed to examine the relationship between the amikacin pharmacokinetics and the biological parameters.
Twenty-one patients were studied. A significant correlation was found between the volume of distribution and ESR (p<0.05, r=0.844). Moreover, drug clearance had a significant inverse correlation with serum lactate (p<0.05, r=-0.603). No other significant correlations were found.
ESR and serum lactate were identified as useful predictors of amikacin pharmacokinetics in critically ill patients with intra-abdominal sepsis and may help guide the selection of appropriate empirical dosing.
本研究旨在评估氨基糖苷类药物药代动力学与腹腔感染危重症患者器官功能障碍相关生物标志物之间的关系。
本病例系列研究纳入了接受氨基糖苷类药物负荷剂量 20-25mg/kg 静脉输注的腹腔感染危重症患者。测定 1、2、4、6 和 24 小时的氨基糖苷类药物血清浓度，以计算药代动力学参数。记录序贯器官衰竭评估（SOFA）评分、白细胞计数、中性粒细胞与淋巴细胞比值、血小板计数、血清肌酐、肌酐清除率、胆红素、氧分压与吸入氧分数比值、血清白蛋白、降钙素原、乳酸水平、红细胞沉降率（ESR）和 C 反应蛋白。采用线性回归分析评估氨基糖苷类药物药代动力学与生物学参数之间的关系。
共纳入 21 例患者。分布容积与 ESR 之间存在显著相关性（p<0.05，r=0.844）。此外，清除率与血清乳酸呈显著负相关（p<0.05，r=-0.603）。未发现其他有意义的相关性。
ESR 和血清乳酸可作为腹腔感染危重症患者氨基糖苷类药物药代动力学的有用预测指标，可能有助于指导经验性用药剂量的选择。
