Granthil C, Savin B, Charrel C T, Martin C, Gouin F, François G
Ann Anesthesiol Fr. 1981;22(2):207-11.
Amikacin serum levels were measured 256 times in 65 patients admitted into the intensive care unit for various reasons over 18 months. These measurements confirmed the dosage of 5 micrograms per kg repeated every 8 hours in patients with normal renal function. Forty eight hours before the first measurement, a control assay is essential to check that there is no residual antibiotic and that the antibacterial activity of the serum is zero. After this a single weekly control is sufficient to check that the residual level is effective and non toxic, i.e. between 2 and 6 micrograms per ml. However, in patients with acute renal insufficiency, there are three dosage schemas which should be used depending on the creatinine level. These three schemas are nevertheless not sufficient to continue effective therapy without a risk of toxic side effects. It is therefore necessary to check both the pack levels and the residual levels regularly from the beginning of treatment. Two to three weekly controls are essential to avoid a risk of toxic side effects.
在18个月期间，对因各种原因入住重症监护病房的65例患者进行了256次阿米卡星血清水平测定。这些测定结果证实，肾功能正常的患者每8小时重复给予5微克/千克的剂量是合适的。在首次测定前48小时，必须进行对照测定，以检查是否没有残留抗生素且血清的抗菌活性为零。在此之后，每周进行一次对照就足以检查残留水平是否有效且无毒，即每毫升2至6微克。然而，对于急性肾功能不全的患者，根据肌酐水平应使用三种剂量方案。然而，这三种方案不足以在不产生毒副作用风险的情况下继续进行有效的治疗。因此，从治疗开始就有必要定期检查血药浓度和残留水平。每周进行两到三次对照对于避免毒副作用风险至关重要。
