Efficacy and safety of once-daily versus twice-daily netilmicin in patients with acute urinary tract infections

Karachalios, George N.; Georgiopoulos, A; Kintziou, Helen; Mitsoga, Chrisoula

doi:10.1016/0011-393x(95)85126-7

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…While aminoglycoside therapy has traditionally been given in multiple daily doses, limited clinical evidence supports oncedaily maintenance dosing of 15 mg/kg of body weight for amikacin and offers advantages in cost and convenience (9,12). However, aminoglycoside clearance can be enhanced in critically ill patients and patients with burn injury (8,19,21), making this target more difficult to achieve.…”

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confidence: 99%

Once-Daily Amikacin Dosing in Burn Patients Treated with Continuous Venovenous Hemofiltration

Akers

Cota

Frei

et al. 2011

Antimicrob Agents Chemother

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Amikacin clearance can be increased in burn injury, which is often complicated by renal insufficiency. Little is known about the impact of renal replacement therapies, such as continuous venovenous hemofiltration (CVVH), on amikacin pharmacokinetics. We retrospectively examined the clinical pharmacokinetics, bacteriology, and clinical outcomes of 60 burn patients given 15 mg/kg of body weight of amikacin in single daily doses. Twelve were treated with concurrent CVVH therapy, and 48 were not. The pharmacodynamic target of >10 for the maximum concentration of drug in serum divided by the MIC (C max /MIC) was achieved in only 8.5% of patients, with a small reduction of C max in patients receiving CVVH and no difference in amikacin clearance. Mortality and burn size were greater in patients who received CVVH. Overall, 172 Gram-negative isolates were recovered from the blood cultures of 39 patients, with amikacin MIC data available for 82 isolates from 24 patients. A 10,000-patient Monte Carlo simulation was conducted incorporating pharmacokinetic and MIC data from these patients. The cumulative fraction of response (CFR) was similar in CVVH and non-CVVH patients. The CFR rates were not significantly improved by a theoretical 20 mg/kg amikacin dose. Overall, CVVH did not appear to have a major impact on amikacin serum concentrations. The low pharmacodynamic target attainment appears to be primarily due to higher amikacin MICs rather than more rapid clearance of amikacin related to CVVH therapy.

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confidence: 99%

Once-Daily Amikacin Dosing in Burn Patients Treated with Continuous Venovenous Hemofiltration

Akers

Cota

Frei

et al. 2011

Antimicrob Agents Chemother

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“…[11][12][13] Numerous published studies have addressed the rate of aminoglycoside-associated nephrotoxicity us-ing different dosing regimens. 8,9,[14][15][16][17][18][19][20][21][22][23] However, small sample sizes leading to insufficient statistical power and conflicting results have failed to produce a definitive conclusion about the efficacy of different dosing regimens in the prevention of nephrotoxicity. Therefore, Bayesian methodology was applied to examine the incidence of aminoglycoside-associated nephrotoxicity with extended-interval dosing, individualized pharmacokinetic monitoring, and multiple-daily dosing.…”

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confidence: 99%

Application of Bayes Theorem to Aminoglycoside‐Associated Nephrotoxicity: Comparison of Extended‐Interval Dosing, Individualized Pharmacokinetic Monitoring, and Multiple‐Daily Dosing

Kim

Bertino

Erb

et al. 2004

The Journal of Clinical Pharma

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The objective of this study was to examine the incidence of aminoglycoside-associated nephrotoxicity related to extended-interval dosing, individualized pharmacokinetic monitoring, and multiple-daily dosing by applying Bayes theorem. An electronic literature search of MEDLINE (1966-2003) and a manual search of references from published meta-analyses and review articles were performed. Studies using extended-interval dosing, individualized pharmacokinetic monitoring, or multiple-daily dosing and reported aminoglycoside-associated nephrotoxicity for patients > or = 16 years of age were included. Quality scores were assigned based on the rigor of definition of aminoglycoside-associated nephrotoxicity, duration of therapy, and length of follow-up of renal function after completion of therapy. Inclusion criteria were then based on these quality scores. Quantitative data on the incidence of aminoglycoside-associated nephrotoxicity were abstracted. Twelve extended-interval dosing studies (n = 916), 10 individualized pharmacokinetic monitoring studies (n = 2066), and 27 multiple-daily dosing studies (n = 4251) met the inclusion criteria. Prior probabilities of aminoglycoside-associated nephrotoxicity were derived from a combination of a review of published studies and expert judgment. The maximum densities for the final posterior probabilities of aminoglycoside-associated nephrotoxicity for extended-interval dosing, individualized pharmacokinetic monitoring, and multiple-daily dosing were located at 12% to 13%, 10% to 11%, and 13% to 14%, respectively. Application of Bayes theorem demonstrates that aminoglycoside dosing by individualized pharmacokinetic monitoring results in less aminoglycoside-associated nephrotoxicity than extended-interval dosing or multiple-daily dosing.

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Miscellaneous antibacterial drugs

Khoo¹,

Walley²

1997

Side Effects of Drugs Annual

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Efficacy and safety of once-daily versus twice-daily netilmicin in patients with acute urinary tract infections

Cited by 3 publications

References 18 publications

Once-Daily Amikacin Dosing in Burn Patients Treated with Continuous Venovenous Hemofiltration

Once-Daily Amikacin Dosing in Burn Patients Treated with Continuous Venovenous Hemofiltration

Application of Bayes Theorem to Aminoglycoside‐Associated Nephrotoxicity: Comparison of Extended‐Interval Dosing, Individualized Pharmacokinetic Monitoring, and Multiple‐Daily Dosing

Miscellaneous antibacterial drugs

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