Kinetics and toxicity of liposomal and conventional amikacin in a patient with multidrug-resistant tuberculosis
The pharmacokinetics and toxicity of liposomal amikacin in a patient treated for advanced pulmonary multidrug-resistant tuberculosis are described. A dose of 20 mg/kg of liposomal amikacin was given on alternate days for 14 days and weekly thereafter for 9 weeks, for a total dose of 20.1 g in 17 div...
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| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 1998-12, Vol.17 (11), p.794-797 |
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| container_title | European journal of clinical microbiology & infectious diseases |
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| creator | WHITEHEAD, T. C LOVERING, A. M CROPLEY, I. M WADE, P DAVIDSON, R. N |
| description | The pharmacokinetics and toxicity of liposomal amikacin in a patient treated for advanced pulmonary multidrug-resistant tuberculosis are described. A dose of 20 mg/kg of liposomal amikacin was given on alternate days for 14 days and weekly thereafter for 9 weeks, for a total dose of 20.1 g in 17 divided doses. Accumulation occurred with alternate-day, but not weekly, dosing. The serum levels of amikacin obtained with the liposomal preparation were considerably greater than those obtained with the conventional preparation (range, 81-457 mg/l vs. 4.1-37.7 mg/l). The liposomal amikacin was well tolerated and led to clinical improvement, but it failed to achieve a microbiological response. The patient's sputum remained smear- and culture-positive during the treatment period with liposomal amikacin and for 9 months afterward. |
| doi_str_mv | 10.1007/s100960050189 |
| format | Article |
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C ; LOVERING, A. M ; CROPLEY, I. M ; WADE, P ; DAVIDSON, R. N</creator><creatorcontrib>WHITEHEAD, T. C ; LOVERING, A. M ; CROPLEY, I. M ; WADE, P ; DAVIDSON, R. N</creatorcontrib><description>The pharmacokinetics and toxicity of liposomal amikacin in a patient treated for advanced pulmonary multidrug-resistant tuberculosis are described. A dose of 20 mg/kg of liposomal amikacin was given on alternate days for 14 days and weekly thereafter for 9 weeks, for a total dose of 20.1 g in 17 divided doses. Accumulation occurred with alternate-day, but not weekly, dosing. The serum levels of amikacin obtained with the liposomal preparation were considerably greater than those obtained with the conventional preparation (range, 81-457 mg/l vs. 4.1-37.7 mg/l). The liposomal amikacin was well tolerated and led to clinical improvement, but it failed to achieve a microbiological response. The patient's sputum remained smear- and culture-positive during the treatment period with liposomal amikacin and for 9 months afterward.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s100960050189</identifier><identifier>PMID: 9923523</identifier><language>eng</language><publisher>Berlin: Springer</publisher><subject>Aged ; Amikacin - administration & dosage ; Amikacin - adverse effects ; Amikacin - pharmacokinetics ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - adverse effects ; Anti-Bacterial Agents - pharmacokinetics ; Antibacterial agents ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antitubercular Agents - therapeutic use ; Biological and medical sciences ; Drug Carriers ; Drug Therapy, Combination ; Humans ; Liposomes ; Male ; Medical sciences ; Mycobacterium ; Mycobacterium tuberculosis - drug effects ; Mycobacterium tuberculosis - isolation & purification ; Pharmacokinetics ; Pharmacology. 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The serum levels of amikacin obtained with the liposomal preparation were considerably greater than those obtained with the conventional preparation (range, 81-457 mg/l vs. 4.1-37.7 mg/l). The liposomal amikacin was well tolerated and led to clinical improvement, but it failed to achieve a microbiological response. The patient's sputum remained smear- and culture-positive during the treatment period with liposomal amikacin and for 9 months afterward.</description><subject>Aged</subject><subject>Amikacin - administration & dosage</subject><subject>Amikacin - adverse effects</subject><subject>Amikacin - pharmacokinetics</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Anti-Bacterial Agents - pharmacokinetics</subject><subject>Antibacterial agents</subject><subject>Antibiotics. Antiinfectious agents. 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The serum levels of amikacin obtained with the liposomal preparation were considerably greater than those obtained with the conventional preparation (range, 81-457 mg/l vs. 4.1-37.7 mg/l). The liposomal amikacin was well tolerated and led to clinical improvement, but it failed to achieve a microbiological response. The patient's sputum remained smear- and culture-positive during the treatment period with liposomal amikacin and for 9 months afterward.</abstract><cop>Berlin</cop><pub>Springer</pub><pmid>9923523</pmid><doi>10.1007/s100960050189</doi><tpages>4</tpages></addata></record> |
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| identifier | ISSN: 0934-9723 |
| ispartof | European journal of clinical microbiology & infectious diseases, 1998-12, Vol.17 (11), p.794-797 |
| issn | 0934-9723 1435-4373 |
| language | eng |
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| subjects | Aged Amikacin - administration & dosage Amikacin - adverse effects Amikacin - pharmacokinetics Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - adverse effects Anti-Bacterial Agents - pharmacokinetics Antibacterial agents Antibiotics. Antiinfectious agents. Antiparasitic agents Antitubercular Agents - therapeutic use Biological and medical sciences Drug Carriers Drug Therapy, Combination Humans Liposomes Male Medical sciences Mycobacterium Mycobacterium tuberculosis - drug effects Mycobacterium tuberculosis - isolation & purification Pharmacokinetics Pharmacology. Drug treatments Sputum - microbiology Treatment Outcome Tuberculosis Tuberculosis, Multidrug-Resistant - drug therapy Tuberculosis, Multidrug-Resistant - metabolism Tuberculosis, Multidrug-Resistant - microbiology |
| title | Kinetics and toxicity of liposomal and conventional amikacin in a patient with multidrug-resistant tuberculosis |
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