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The American Journal of the Medical... 1977Amikacin is a new aminoglycoside antibiotic related chemically to kanamycin. It has broad spectrum activity against most gram-negative bacilli. The most important...
Amikacin is a new aminoglycoside antibiotic related chemically to kanamycin. It has broad spectrum activity against most gram-negative bacilli. The most important advantage of this aminoglycoside is its activity against gram-negative bacilli which are resistant to gentamicin. Amikacin was given to 22 cancer patients with 24 serious infections produced by gram-negative bacilli resistant to gentamicin and 13 (54 per cent) were cured. Response to amikacin was related to the patients's neutrophil count at the time of infection; neutropenic patients having a lower response rate (30 per cent vs 71 per cent). Side effects included nephrotoxicity (12 per cent) and audiotoxicity (5 per cent). Amikacin is an effective new antibiotic for patients with severe infections produced by gram-negative bacilli resistant to gentamicin.
Topics: Adult; Aged; Amikacin; Bacteria; Bacterial Infections; Drug Evaluation; Drug Resistance, Microbial; Female; Gentamicins; Humans; Kanamycin; Male; Microbial Sensitivity Tests; Middle Aged
PubMed: 860733
DOI: 10.1097/00000441-197703000-00007 -
Tidsskrift For Den Norske Laegeforening... Apr 1978
Topics: Amikacin; Anti-Bacterial Agents; Chemical Phenomena; Chemistry; Drug Resistance; Humans; Kanamycin; Tobramycin
PubMed: 653664
DOI: No ID Found -
Indian Journal of Dermatology,... 2009
Topics: Amikacin; Buttocks; Child; Child, Preschool; Humans; Injections, Intramuscular; Lipodystrophy; Male
PubMed: 19736463
DOI: 10.4103/0378-6323.55431 -
Antimicrobial Agents and Chemotherapy Jul 1990Pressure sores are a common occurrence in immobilized patients. They increase morbidity and mortality and impede rehabilitation. Antibiotics are routinely used to assist...
Pressure sores are a common occurrence in immobilized patients. They increase morbidity and mortality and impede rehabilitation. Antibiotics are routinely used to assist in effecting a cure when infection is present. Nevertheless, for patients with spinal cord injuries (SCI), strategies for effective therapy with antibiotics based on measurement of concentrations in tissue and pharmacokinetic behavior in extravascular spaces do not exist. By analyzing the concentration-time profile and protein binding of amikacin in the interstitial fluid (IF) in contact with pressure sores, we found that the disposition of amikacin in the tissue contiguous with pressure sores appears to be governed by simultaneous first-order and capacity-limited pharmacokinetic behavior. Amikacin disposition in IF proceeded without a simple relationship to amikacin concentrations in serum, and the time course in IF was not accurately simulated by linear models of amikacin pharmacokinetic behavior. Total amikacin clearance estimated from a pharmacokinetic model using simultaneous first-order and nonlinear intercompartmental transfer of amikacin was not significantly different from clearance calculated by us in a prior study of amikacin pharmacokinetic behavior in patients with SCI. In patients with SCI, optimal use of amikacin in the treatment of infected pressure sores is contingent upon accurate characterization of the pharmacokinetic behavior of this aminoglycoside in serum and in the IF in contact with these lesions. Only methods which quantitate amikacin concentration and protein binding in IF and incorporate a model that can simultaneously simulate nonlinear and linear disposition processes should be relied upon to influence therapeutic decision making.
Topics: Adult; Aged; Amikacin; Blood Proteins; Humans; Male; Middle Aged; Pressure Ulcer; Protein Binding; Spinal Cord Injuries
PubMed: 2386372
DOI: 10.1128/AAC.34.7.1422 -
The Journal of Infectious Diseases Nov 1976Six patients with acute gram-negative bronchopulmonary infection were treated with amikacin (15 mg/kg per day) administered intramuscularly in two equal doses at 12-hr...
Six patients with acute gram-negative bronchopulmonary infection were treated with amikacin (15 mg/kg per day) administered intramuscularly in two equal doses at 12-hr intervals for 10-13 days. Two patients had underlying nonspecific pulmonary disease, two had advanced bronchocarcinoma, and two had extensive bronchiectasis (due to chronic aspergillosis in one patient). The pathogens were Pseudomonas aeruginosa in three patients, and Haemophilus influenzae, Klebsiella ozaenae, and Enterobacter cloacae each in one patient. Five patients recovered completely, with resolution of fever and other acute symptoms and elimination of the causative organism from sputum cultures. A moribund patient with advanced metastatic bronchocarcinoma died two days after the treatment with amikacin had been completed; the last specimen of sputum was still positive for P. aeruginosa. Tests of liver and renal function and blood counts revealed no abnormaltities. Complete audiometric survey showed no hearing loss. Nystagmography revealed reversible, lessened caloric response in some patients. Amikacin was well absorbed from the site of intramuscular injection. Levels of amikacin in serum varied among the subjects and, in some cases, for individual patients on different days.
Topics: Acute Disease; Adult; Aged; Amikacin; Enterobacteriaceae Infections; Haemophilus Infections; Haemophilus influenzae; Humans; Kanamycin; Middle Aged; Pseudomonas Infections; Respiratory Tract Infections
PubMed: 1086876
DOI: 10.1093/infdis/135.supplement_2.s391 -
Antimicrobial Agents and Chemotherapy Feb 1990The pharmacokinetics of amikacin administered intravenously at currently recommended doses (7.5 mg/kg every 12 h for infants with less than 7 days of life; 7.5 mg/kg...
The pharmacokinetics of amikacin administered intravenously at currently recommended doses (7.5 mg/kg every 12 h for infants with less than 7 days of life; 7.5 mg/kg every 8 h for infants with greater than 7 days of life) were studied in 28 preterm infants weighing less than 2,500 g (mean +/- standard deviation, 1.38 +/- 0.47 kg; postconceptional age, 30.50 +/- 2.86 weeks). The medication was infused over 45 min. Trough and peak serum samples as well as two additional samples were taken at steady state. The results showed a statistically significant inverse relationship between half-life (8.42 +/- 2.55 h) and postconceptional age (P = 0.002) and a direct correlation between total body clearance (0.84 +/- 0.28 ml/min per kg) and postconceptional age (P = 0.02). These pharmacokinetic data were used to calculate a new dosage schedule for preterm infants. The derived intravenous dosage of amikacin for infants of less than 30 weeks of postconceptional age was 9 mg/kg every 18 h. For infants of greater than 30 weeks of postconceptional age, the dosage was 9 mg/kg every 12 h. Peak and trough levels of amikacin in serum that fell within the therapeutic range were compared by using the currently recommended dosage schedule and the dosage schedule derived from our pharmacokinetic data. There was a reduction in the number of peak and trough levels that fell outside the accepted therapeutic range which was not statistically significant. Extension of the dosing interval and a further increase in the dosage may result in further improvement. Based on these data, the current recommendations are inadequate for the preterm infant. Our derived dosage schedule improved but did not eliminate high trough and low peak levels of amikacin in all infants. The current recommendations should be adjusted for the preterm infant. Ongoing therapeutic drug monitoring is essential to tailor the amikacin dosage to the individual patient.
Topics: Amikacin; Female; Gestational Age; Half-Life; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Male; Pregnancy
PubMed: 2327775
DOI: 10.1128/AAC.34.2.265 -
Developmental Pharmacology and... 1991A dosing chart for amikacin (AMK) was developed from average pharmacokinetic parameters for infants with varying postnatal ages and birth weights ranging from less than... (Comparative Study)
Comparative Study
A dosing chart for amikacin (AMK) was developed from average pharmacokinetic parameters for infants with varying postnatal ages and birth weights ranging from less than 800 to greater than 2,500 g. This chart was then evaluated in 38 infants (648-5,404 g; 25-43 weeks postconceptional age, estimated glomerular filtration rate (GFR) 9.0-49.0 ml/min/1.73 m2) with suspected infection by comparison of predicted versus observed steady-state peak (Cssmax) and trough (Cssmin) serum AMK concentrations. Additionally, the apparent elimination half-life (t1/2) for AMK was determined for each infant using two postinfusion serum concentrations obtained at steady state. As expected, linear correlations were found between the elimination rate constant (Ke) for AMK and both postconceptional age (PCA; y = -0.54 + 0.005x; r = 0.59, p less than 0.01) and estimated GFR (y = 0.05 + 0.002x; r = 0.65; p less than 0.01). The dosing chart produced desired therapeutic Cssmax values (e.g. 20-30 micrograms/ml) in 76.3% of patients, with 2.6 and 21.1% having values less than 20 and greater than 30 micrograms/ml, respectively. Desired therapeutic Cssmin serum AMK concentrations (e.g. 4-10 micrograms/ml) were obtained in 71.1% of patients, with 10.5 and 18.4% having concentrations of less than 4 and greater than 10 micrograms/ml, respectively. However, significant linear correlations were not found between the predicted versus observed values for either Cssmax or Cssmin. The AMK dosing chart for neonates enables attainment of desired therapeutic serum concentrations in the majority of infants at the initiation of therapy despite wide variability in PCA, birth weights and estimated GFR.
Topics: Age Factors; Amikacin; Bacterial Infections; Data Collection; Drug Administration Schedule; Evaluation Studies as Topic; Female; Glomerular Filtration Rate; Half-Life; Humans; Infant; Infant, Newborn; Infusions, Intravenous; Male; Metabolic Clearance Rate; Prospective Studies
PubMed: 1782838
DOI: No ID Found -
Spectrochimica Acta. Part A, Molecular... May 2019Amikacin, a molecule formed by two glucosamine rings linked by α-linkages through a central deoxystreptamine, is an antibiotic often used in clinical treatments, with a...
Amikacin, a molecule formed by two glucosamine rings linked by α-linkages through a central deoxystreptamine, is an antibiotic often used in clinical treatments, with a special attention in the pediatric cases, due to the physiological activity of their renal system. In spite of its extensive use, no detailed information about the vibrational features of the molecule is available in the literature. Thus, in this study we performed a comprehensive vibrational investigation of amikacin from both an experimental and theoretical point of view. Raman and IR spectroscopy combined with DFT calculations conducted to a complete vibrational characterization of the molecule, with the assignment of the vibrational modes. Moreover, SERS spectrum was recorded and analyzed and provided information about the adsorption behavior of the amikacin on the silver nanoparticles surface.
Topics: Amikacin; Models, Molecular; Molecular Structure; Spectrophotometry, Infrared; Spectrum Analysis, Raman
PubMed: 30769154
DOI: 10.1016/j.saa.2019.02.012 -
Chest Apr 1984The pharmacokinetics of amikacin after intravenous (IV) and intrapleural injection was compared in 25 patients with pleural drainage after lung resection. In ten...
The pharmacokinetics of amikacin after intravenous (IV) and intrapleural injection was compared in 25 patients with pleural drainage after lung resection. In ten patients 7.5 mg/kg of the drug was injected IV; the mean peak concentrations were 31.2 +/- 2.3 micrograms/ml in the serum and 13.3 +/- 3.8 micrograms/ml in the pleural fluid. The penetration of amikacin in the pleural space was 80 percent. After the intrapleural injection of the same dose of amikacin in 15 patients, the pleural fluid concentrations of the drug were extremely high and well sustained during eight hours; however, serum concentrations reached maximal values of 14.1 +/- 4.7 micrograms/ml, indicating a substantial diffusion of amikacin from the pleural space to the blood. In the case of treatment of pleural infections by local injection of aminoglycosides, the serum concentrations must be kept in mind to avoid systemic intoxication from these drugs.
Topics: Adult; Aged; Amikacin; Exudates and Transudates; Humans; Injections; Injections, Intravenous; Kanamycin; Middle Aged; Pleura; Thoracic Surgery
PubMed: 6705579
DOI: 10.1378/chest.85.4.502 -
Archives of Ophthalmology (Chicago,... Oct 1986Intravitreal administration of broad-spectrum antibiotics is a widely accepted component of initial therapy for bacterial endophthalmitis. Four cases of culture-proved...
Intravitreal administration of broad-spectrum antibiotics is a widely accepted component of initial therapy for bacterial endophthalmitis. Four cases of culture-proved bacterial endophthalmitis are reported to demonstrate the safety of intravitreal administration of amikacin sulfate in conjunction with cephalosporins in patients. The benefits of using amikacin rather than gentamicin sulfate in intravitreal drug therapy are discussed, and a wider role for amikacin as the aminoglycoside of choice for initial intravitreal injection in presumed bacterial endophthalmitis is suggested.
Topics: Aged; Amikacin; Bacterial Infections; Child, Preschool; Female; Humans; Male; Middle Aged; Panophthalmitis; Vitreous Body
PubMed: 3767678
DOI: 10.1001/archopht.1986.01050220077030