肾衰竭和透析对氨基糖苷类药物阿米卡星血清浓度的影响。
Effect of renal failure and dialysis on the serum concentration of the aminoglycoside amikacin.
作者信息
Madhavan T, Yaremchuk K, Levin N, Pohlod D, Burch K, Fisher E, Cox F, Quinn E L
出版信息
Antimicrob Agents Chemother. 1976 Sep;10(3):464-6. doi: 10.1128/AAC.10.3.464.
Serum and dialysate levels of amikacin were determined at appropriate intervals after a 300-mg intravenous dose as a continuous infusion in six patients with end-stage renal failure undergoing hemodialysis and in three patients on peritoneal dialysis. The mean serum half-life of amikacin was 3.75 h during (or after) hemodialysis and 29 h during (or after) peritoneal dialysis. Although not on hemodialysis in the same six patients, the serum half-life was 28 h. The results indicate that the maintenance dose of amikacin should be markedly decreased in patients with severe renal failure even if they are treated with peritoneal dialysis, and that serial serum antibiotic concentrations are essential to prevent cumulative toxicity of the drug.
对6例接受血液透析的终末期肾衰竭患者和3例接受腹膜透析的患者，静脉注射300mg阿米卡星后持续输注，在适当的间隔时间测定血清和透析液中阿米卡星的水平。在血液透析期间（或之后），阿米卡星的平均血清半衰期为3.75小时，在腹膜透析期间（或之后）为29小时。虽然这6例患者未进行血液透析，但其血清半衰期为28小时。结果表明，即使是接受腹膜透析治疗的严重肾衰竭患者，阿米卡星的维持剂量也应显著降低，并且连续监测血清抗生素浓度对于预防药物的累积毒性至关重要。
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