Evaluation of the effectiveness of treatment with Amikacin through tracking drug concentration in the blood of patients at the Department of Kidney - Urology Surgery, Gia Dinh People's Hospital

Abstract

    Amikacin is an aminoglycoside antibiotic used in clinical practice for the treatment of life-threatening severe aerobic Gram (-) infections that threaten the patient's life. However, this is a concentration-dependent antibiotic and has a narrow therapeutic range, the highest toxicity is nephrotoxicity and ototoxicity. Therefore, to use amikacin effectively and safely, it is necessary to strictly adhere to indications, dosage regimen and reasonable monitoring. From there, detect toxicity early and adjust the dose for the patient. From investigation of amikacin blood levels of patients with average age (57.0 ± 15.3) years old, hospital stay (6.8 ± 2.4) days, with average dose (13.6 ± 2.3) mg/ kg/day, results have been obtained Cmid-level at (9 – 12) hours has 36.4 % of patients in the 24-hour region, 59.1 % below the detection threshold and 4.5% above the 24-hour region. At the dose regime multiple daily dosing day (MDD) within the therapeutic range, 87.5% of patients had peak concentration (Cpeak). Peak once-daily dosing (ODD) concentrations in only 9.1 % of patients reached the therapeutic range. The trough concentration (Ctrough) in the ODD dose regimen of patients above the therapeutic threshold was 23.1 %. 5 % of patients with nephrotoxicity in which 2.5 % of patients with acute renal failure after 3 days. Hearing and vestibular abnormalities were not detected during treatment.