نشانگرهای اختلال عملکرد اندام ممکن است فارماکوکینتیک آمینوگلیکوزیدها را در بیماران بدحال مبتلا به سپسیس شکمی پیش بینی کنند

عنوان انگليسی

Organ dysfunction markers may predict aminoglycoside pharmacokinetics in critically ill patients with abdominal sepsis

خلاصه انگلیسی

Introduction: Pathophysiological changes and organ dysfunction following sepsis alter antibiotic pharmacokinetics. In the absence of pharmacokinetic data at the time of empirical treatment initiation, available biomarkers could play an important role in predicting the pharmacokinetic parameters. Objectives: This study aimed to evaluate the relationship between the amikacin pharmacokinetics and the biomarkers associated with organ dysfunction in critically ill patients with intra-abdominal sepsis. Methods: A case series involving critically ill patients with intraabdominal sepsis who received an amikacin loading dose of 20-25 mg/kg intravenous infusion, was studied. The 1-, 2-, 4-, and 6-h amikacin serum concentrations were measured to calculate the pharmacokinetic parameters. The available biomarkers associated with organ dysfunction were recorded. A linear regression analysis was performed to examine the relationship between the amikacin pharmacokinetics and the biological parameters. Results: Twenty-one patients were studied. A significant correlation was found between the volume of distribution and ESR (p < 0.05, r = 0.844). Moreover, drug clearance had a significant inverse correlation with serum lactate (p < 0.05, r = -0.603). No other significant correlations were found. Conclusion: ESR and serum lactate were identified as useful predictors of amikacin pharmacokinetics in critically ill patients with intra-abdominal sepsis and may help guide the selection of appropriate empirical dosing. Further studies are required to confirm these findings.

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