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Open AccessArticle

Population Pharmacokinetics Analysis of Amikacin Initial Dosing Regimen in Elderly Patients

1
Department of Clinical Infectious Diseases, Aichi Medical University, Aichi 480-1195, Japan
2
University of Queensland Centre for Clinical Research, The University of Queensland, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: George Panos
Received: 7 December 2020 / Revised: 14 January 2021 / Accepted: 19 January 2021 / Published: 20 January 2021
(This article belongs to the Special Issue Clinical Approach to Antibiotic Resistance: The Definitive Issue)
There are limited data of amikacin pharmacokinetics (PK) in the elderly population. Hence, we aimed to describe the population PK of amikacin in elderly patients (>70 years old) and to establish optimized initial dosing regimens. We simulated individual maximum concentrations in plasma (Cmax) and minimal concentrations (Cmin) for several dosing regimens (200–2000 mg every 24, 48, and 72 h) for patients with creatinine clearance (CCr) of 10–90 mL/min and analyzed efficacy (Cmax/minimal inhibitory concentration (MIC) ≥ 8) for MICs of 4, 8, and 16 mg/L and safety (Cmin < 4 mg/L). A one-compartment model best described the data. CCr was the only covariate associated with amikacin clearance. The population PK parameter estimates were 2.25 L/h for clearance and 18.0 L for volume of distribution. Dosing simulations recommended the dosing regimens (1800 mg) with dosing intervals ranging 48–72 h for patients with CCr of 40–90 mL/min based on achievement of both efficacy for the MIC of 8 mg/L and safety. None of the dosing regimens achieved the targets for an MIC of 16 mg/L. We recommend the initial dosing regimen using a nomogram based on CCr for an MIC of ≤8 mg/L in elderly patients with CCr of 40–90 mL/min. View Full-Text
Keywords: population pharmacokinetics analysis; amikacin; elderly; Pseudomonas aeruginosa population pharmacokinetics analysis; amikacin; elderly; Pseudomonas aeruginosa
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MDPI and ACS Style

Kato, H.; Parker, S.L.; Roberts, J.A.; Hagihara, M.; Asai, N.; Yamagishi, Y.; Paterson, D.L.; Mikamo, H. Population Pharmacokinetics Analysis of Amikacin Initial Dosing Regimen in Elderly Patients. Antibiotics 2021, 10, 100. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020100

AMA Style

Kato H, Parker SL, Roberts JA, Hagihara M, Asai N, Yamagishi Y, Paterson DL, Mikamo H. Population Pharmacokinetics Analysis of Amikacin Initial Dosing Regimen in Elderly Patients. Antibiotics. 2021; 10(2):100. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020100

Chicago/Turabian Style

Kato, Hideo; Parker, Suzanne L.; Roberts, Jason A.; Hagihara, Mao; Asai, Nobuhiro; Yamagishi, Yuka; Paterson, David L.; Mikamo, Hiroshige. 2021. "Population Pharmacokinetics Analysis of Amikacin Initial Dosing Regimen in Elderly Patients" Antibiotics 10, no. 2: 100. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics10020100

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