Therapeutic Drug Monitoring of Amikacin in Neutropenic Oncology Patients
Amikacin is the antibiotic of choice for the treatment of Gram-negative infections, namely, those in neutropenic oncology patients. No populational pharmacokinetic studies are currently available reporting amikacin pharmacokinetics in neutropenic oncology patients despite their specific pathophysiol...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/2/373 |
| _version_ | 1797622783415418880 |
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| author | Maria Aquino Maria Tinoco Joana Bicker Amílcar Falcão Marília Rocha Ana Fortuna |
| author_facet | Maria Aquino Maria Tinoco Joana Bicker Amílcar Falcão Marília Rocha Ana Fortuna |
| author_sort | Maria Aquino |
| collection | DOAJ |
| description | Amikacin is the antibiotic of choice for the treatment of Gram-negative infections, namely, those in neutropenic oncology patients. No populational pharmacokinetic studies are currently available reporting amikacin pharmacokinetics in neutropenic oncology patients despite their specific pathophysiological features and treatments. A large-scale retrospective study was herein conducted to specifically investigate the effects that tumor diseases have on the pharmacokinetic parameters of amikacin and identify whether chemotherapy, the lag time between administration of chemotherapy and amikacin, age and renal function contribute to amikacin pharmacokinetics in neutropenic cancer patients. A total of 1180 pharmacokinetic analysis from 629 neutropenic patients were enrolled. The daily dose administered to oncology patients was higher than that administered to non-oncology patients (<i>p</i> < 0.0001). No statistical differences were found in amikacin concentrations, probably because drug clearance was increased in cancer patients (<i>p</i> < 0.0001). Chemotherapy influenced amikacin pharmacokinetics and drug clearance decreased as the lag time enhanced. The elderly group revealed no statistical differences between the doses administered to both the oncology groups, suggesting that the impact of ageing is stronger than chemotherapy. Our research suggests that cancer patients require higher initial doses of amikacin, as well as when chemotherapy is received less than 30 days before amikacin treatment has started. |
| first_indexed | 2024-03-11T09:15:10Z |
| format | Article |
| id | doaj.art-9456b2adce564e09811156e7448e90ae |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T09:15:10Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-9456b2adce564e09811156e7448e90ae2023-11-16T18:44:06ZengMDPI AGAntibiotics2079-63822023-02-0112237310.3390/antibiotics12020373Therapeutic Drug Monitoring of Amikacin in Neutropenic Oncology PatientsMaria Aquino0Maria Tinoco1Joana Bicker2Amílcar Falcão3Marília Rocha4Ana Fortuna5Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, PortugalLaboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, PortugalLaboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, PortugalLaboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, PortugalCentro Hospitalar e Universitário de Coimbra (CHUC, EPE), 3000-548 Coimbra, PortugalLaboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, 3000-548 Coimbra, PortugalAmikacin is the antibiotic of choice for the treatment of Gram-negative infections, namely, those in neutropenic oncology patients. No populational pharmacokinetic studies are currently available reporting amikacin pharmacokinetics in neutropenic oncology patients despite their specific pathophysiological features and treatments. A large-scale retrospective study was herein conducted to specifically investigate the effects that tumor diseases have on the pharmacokinetic parameters of amikacin and identify whether chemotherapy, the lag time between administration of chemotherapy and amikacin, age and renal function contribute to amikacin pharmacokinetics in neutropenic cancer patients. A total of 1180 pharmacokinetic analysis from 629 neutropenic patients were enrolled. The daily dose administered to oncology patients was higher than that administered to non-oncology patients (<i>p</i> < 0.0001). No statistical differences were found in amikacin concentrations, probably because drug clearance was increased in cancer patients (<i>p</i> < 0.0001). Chemotherapy influenced amikacin pharmacokinetics and drug clearance decreased as the lag time enhanced. The elderly group revealed no statistical differences between the doses administered to both the oncology groups, suggesting that the impact of ageing is stronger than chemotherapy. Our research suggests that cancer patients require higher initial doses of amikacin, as well as when chemotherapy is received less than 30 days before amikacin treatment has started.https://www.mdpi.com/2079-6382/12/2/373antibioticstherapeutic drug monitoringamikacintumorneutropeniapharmacokinetics |
| spellingShingle | Maria Aquino Maria Tinoco Joana Bicker Amílcar Falcão Marília Rocha Ana Fortuna Therapeutic Drug Monitoring of Amikacin in Neutropenic Oncology Patients Antibiotics antibiotics therapeutic drug monitoring amikacin tumor neutropenia pharmacokinetics |
| title | Therapeutic Drug Monitoring of Amikacin in Neutropenic Oncology Patients |
| title_full | Therapeutic Drug Monitoring of Amikacin in Neutropenic Oncology Patients |
| title_fullStr | Therapeutic Drug Monitoring of Amikacin in Neutropenic Oncology Patients |
| title_full_unstemmed | Therapeutic Drug Monitoring of Amikacin in Neutropenic Oncology Patients |
| title_short | Therapeutic Drug Monitoring of Amikacin in Neutropenic Oncology Patients |
| title_sort | therapeutic drug monitoring of amikacin in neutropenic oncology patients |
| topic | antibiotics therapeutic drug monitoring amikacin tumor neutropenia pharmacokinetics |
| url | https://www.mdpi.com/2079-6382/12/2/373 |
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