Amikacin Dosing for MDR Tuberculosis: A Systematic Review to Establish or Revise the Current Recommended Dose for Tuberculosis Treatment

Amikacin Dosing for MDR Tuberculosis: A Systematic Review to Establish or Revise the Current Recommended Dose for Tuberculosis Treatment

Abstract Background Amikacin has been used for over 40 years in multidrug resistant tuberculosis (MDR-TB), but there is still debate on the right dose. The aim of this review was to search relevant pharmacokinetic (PK) and pharmacodynamic (PD) literature for the optimal dose and dosing frequency of...

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Veröffentlicht in:Clinical infectious diseases 2018-11, Vol.67 (suppl_3), p.S303-S307
Hauptverfasser: Sturkenboom, Marieke G G, Simbar, Noviana, Akkerman, Onno W, Ghimire, Samiksha, Bolhuis, Mathieu S, Alffenaar, Jan-Willem C
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container_end_page S307
container_issue suppl_3
container_start_page S303
container_title Clinical infectious diseases
container_volume 67
creator Sturkenboom, Marieke G G
Simbar, Noviana
Akkerman, Onno W
Ghimire, Samiksha
Bolhuis, Mathieu S
Alffenaar, Jan-Willem C
description Abstract Background Amikacin has been used for over 40 years in multidrug resistant tuberculosis (MDR-TB), but there is still debate on the right dose. The aim of this review was to search relevant pharmacokinetic (PK) and pharmacodynamic (PD) literature for the optimal dose and dosing frequency of amikacin in MDR-TB regimens trying to optimize efficacy while minimizing toxicity. Methods A systematic review on the value of amikacin as second-line drug in the treatment of MDR-TB was performed. Results Five articles were identified with data on PK, hollow-fiber system model for TB and or early bactericidal activity of amikacin. Despite the long period in which amikacin has been available for the treatment of MDR-TB, very little PK data is available. This highlights the need for more research. Conclusions Maximum concentration (Cmax) of amikacin related to MIC proved to be the most important PK/PD index for efficacy. The target Cmax/MIC ratio should be 10 at site of infection. Cumulative area under the concentration-time curve (AUC) corresponding with cumulative days of treatment was associated with an increased risk of toxicity.
doi_str_mv 10.1093/cid/ciy613
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The aim of this review was to search relevant pharmacokinetic (PK) and pharmacodynamic (PD) literature for the optimal dose and dosing frequency of amikacin in MDR-TB regimens trying to optimize efficacy while minimizing toxicity. Methods A systematic review on the value of amikacin as second-line drug in the treatment of MDR-TB was performed. Results Five articles were identified with data on PK, hollow-fiber system model for TB and or early bactericidal activity of amikacin. Despite the long period in which amikacin has been available for the treatment of MDR-TB, very little PK data is available. This highlights the need for more research. Conclusions Maximum concentration (Cmax) of amikacin related to MIC proved to be the most important PK/PD index for efficacy. The target Cmax/MIC ratio should be 10 at site of infection. Cumulative area under the concentration-time curve (AUC) corresponding with cumulative days of treatment was associated with an increased risk of toxicity.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/ciy613</identifier><identifier>PMID: 30496466</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>Clinical infectious diseases, 2018-11, Vol.67 (suppl_3), p.S303-S307</ispartof><rights>The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. 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source JSTOR Archive Collection A-Z Listing; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
title Amikacin Dosing for MDR Tuberculosis: A Systematic Review to Establish or Revise the Current Recommended Dose for Tuberculosis Treatment
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