Once-daily dosing of amikacin for treatment of Mycobacterium abscessus lung disease

H. Lee, Y. M. Sohn, J. Y. Ko, S. Y. Lee, B. W. Jhun, H. Y. Park, K. Jeon, D. H. Kim, S. Y. Kim, J. E. Choi, I. J. Moon, S. J. Shin, H. J. Park, W. J. Koh

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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 (Cmax), the Cmax, target of 55-65 μg/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). CONC LUS ION: Our results suggest that once-daily AMK for 4 weeks with a target max of 55-65 μg/ml can be used in patients with M. abscessus lung disease, with careful monitoring of toxicity.

Original languageEnglish
Pages (from-to)818-824
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume21
Issue number7
DOIs
Publication statusPublished - 2017 Jul 1

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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    Lee, H., Sohn, Y. M., Ko, J. Y., Lee, S. Y., Jhun, B. W., Park, H. Y., Jeon, K., Kim, D. H., Kim, S. Y., Choi, J. E., Moon, I. J., Shin, S. J., Park, H. J., & Koh, W. J. (2017). Once-daily dosing of amikacin for treatment of Mycobacterium abscessus lung disease. International Journal of Tuberculosis and Lung Disease, 21(7), 818-824. https://doi.org/10.5588/ijtld.16.0791