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Cited by 70 publications
(65 citation statements)
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References 37 publications
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“…On the basis of these findings the authors concluded that a minimum LD of 25 mg/kg of amikacin has to be administered in this patient population due to the enlargement in Vd [12]. In agreement with the results of this latter study, Galvez and coworkers carried out ExtraVd a prospective randomized trial among 120 patients with severe sepsis and septic shock in order to test if a LD of amikacin of 30 mg/kg could be more suitable than that of 25 mg/kg for promptly optimizing plasma exposure [13]. Amikacin C max resulted significantly higher in patients receiving 30 mg/kg than in those treated with 25 mg/kg (72.1 ± 18.54 mg/L vs 57.4 vs 9.8 mg/L, p < 0.001), and considering that optimal C max of > 60 mg/L was achieved in more than 75 % of cases with the former dosage, the authors concluded that 30 mg/kg should be considered the most suitable LD for amikacin in septic patients.…”
Section: Hydrophilic Antimicrobialsmentioning
confidence: 63%
“…On the basis of these findings the authors concluded that a minimum LD of 25 mg/kg of amikacin has to be administered in this patient population due to the enlargement in Vd [12]. In agreement with the results of this latter study, Galvez and coworkers carried out ExtraVd a prospective randomized trial among 120 patients with severe sepsis and septic shock in order to test if a LD of amikacin of 30 mg/kg could be more suitable than that of 25 mg/kg for promptly optimizing plasma exposure [13]. Amikacin C max resulted significantly higher in patients receiving 30 mg/kg than in those treated with 25 mg/kg (72.1 ± 18.54 mg/L vs 57.4 vs 9.8 mg/L, p < 0.001), and considering that optimal C max of > 60 mg/L was achieved in more than 75 % of cases with the former dosage, the authors concluded that 30 mg/kg should be considered the most suitable LD for amikacin in septic patients.…”
Section: Hydrophilic Antimicrobialsmentioning
confidence: 63%
“…Indeed, this dose and dosing interval led to the optimal amikacin exposure, as this dosing regimen provides the largest difference between the efficacy and the toxicity probability (23). Several studies have reported that the pharmacokinetics of aminoglycosides are altered in critically ill patients, leading to a C max lower than the targeted C max in 30 to 40% of critically ill patients using standard dosing regimens (24)(25)(26)(27). The increased volume of distribution observed in critically ill patients and the concentration-dependent killing activity of aminoglycosides support the use of regimens with higher doses of amikacin to achieve adequate C max s. The use of dosing regimens of Ն25 mg/kg in critically ill patients has been suggested by several authors and recommended by some national guidelines (13,24,27,28).…”
Section: Discussionmentioning
confidence: 99%
“…Nevertheless, achieving the corresponding serum concentrations of AMK in patients is unlikely with conventional dosing of 15 mg/kg body weight/day. AMK doses exceeding 25 mg/kg/day may achieve serum drug levels of Ն60 g/ml, which approaches concentrations of 4ϫ the MIC for strains with MICs of 16 but not 32 g/ml (12)(13)(14).…”
mentioning
confidence: 99%