Once-daily dosing of amikacin for treatment of Mycobacterium abscessus lung disease
- Authors
- Lee, Hyun; Sohn, You Min; Lee, Soo-youn; Ko, J.Y.; Jhun, Byung-woo; Park, Hye-yun; Jeon, Kyeongman; Kim, Dae-hun; Kim, Su-young; Choi, Ji-eun; Moon, Il-joon; Shin, Sung-jae; Park, Hyojung; Koh, Wonjung
- Issue Date
- Jul-2017
- Publisher
- INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)
- Keywords
- non-tuberculous mycobacteria; M. abscessus; AMK; nephrotoxicity; ototoxicity
- Citation
- INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, v.21, no.7, pp.818 - 824
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE
- Volume
- 21
- Number
- 7
- Start Page
- 818
- End Page
- 824
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/3508
- DOI
- 10.5588/ijtld.16.0791
- ISSN
- 1027-3719
- Abstract
- SETTING: Tertiary referral centre, Samsung Medical Center, South Korea.
OBJECTIVE: To evaluate the pharmacokinetic parameters and toxicities of once-daily amikacin (AMK) dosing for lung disease due to Mycobacterium abscessus.
DESIGN: A retrospective review of 48 patients with M. abscessus lung disease who received once-daily AMK for 4 weeks between January 2012 and June 2015.
RESULTS: With a starting dose of 15 mg/kg/day and adjustment of AMK dose according to the peak serum level (C-max), the C-max target of 55-65 mu g/ml was achieved in 31.3% (15/48) of patients in the first week, 68.8% (33/48) in week 2, 91.7% (44/48) in week 3 and 95.8% (46/48) in week 4. Transient nephrotoxicity developed in 6.3% (3/48) of patients and ototoxicity in 25.0% (6/24), which was determined by audiogram as hearing loss, asymptomatic in five patients and tinnitus in one. Multivariate analysis revealed that the highest drug concentration 12 h after administration was significantly associated with the development of toxicities (adjusted odds ratio 1.862, P = 0.047).
CONCLUSION: Our results suggest that once-daily AMK for 4 weeks with a target C-max of 55-65 mu g/ml can be used in patients with M. abscessus lung disease, with careful monitoring of toxicity.
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