Analysis of Amikacin in elderly inpatients in our hospital
WANG Wentao1 TU Chunlin2▲
1.Department of Respiratory Medicine, Weifang Medical University, Shandong Province, Weifang 261000, China;
2.Department of Respiratory Medicine, Jiading Central Hospital of Shanghai City, Shanghai 201800, China
Abstract：Objective To analyze the situations of Amikacin (AMK) applied in elderly inpatients in Jiading Central Hospital of Shanghai City ("our hospital" for short), to promote rational drug use in the clinic. Methods The clinical data of elderly inpatients who used AMK in our hospital from January 2015 to December 2016 was analyzed retrospectively, which contained diagnosis, microbial culture, renal function, AMK dosage regimen, curative effect and adverse reactions, etc, then statistic analysis was made. Results Four hundred and eighty-eight patients (288 male, 200 female) were enrolled in the analysis, aged from 65 to 92 years old, with an average of (70.00±8.40) years old. AMK was used most commonly in Department of Respiratory Medicine (43.65%). AMK was often used in combination with β-lactam antibiotics (61.68%) to against gram-negative bacterial infection (94.26%), and the total effective rate was 89.75%. The drug utilization index of AMK was 0.53, and the most commonly prescribed drug regimen was "0.4 g qd" (62.91%). The levels of serum creatinine of 7 patients after treatment were significantly higher than those before treatment, which may had potential renal toxicity. Conclusion The dosage of AMK in our hospital is relatively low. It is necessary to take blood drug concentration monitoring in the course of clinical treatment and make individualized drug regimen, so as to make sure that the treatment is safe and effective.
王文韬1 屠春林2▲. 我院老年住院患者阿米卡星用药分析[J]. 中国医药导报, 2018, 15(2): 123-126.
WANG Wentao1 TU Chunlin2▲. Analysis of Amikacin in elderly inpatients in our hospital. 中国医药导报, 2018, 15(2): 123-126.
[1] Jackson J，Chen C，Buising K. Aminoglycosides [J]. Curr Opin Infect Dis，2013，26（6）：516-525.
[2] WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index 2014 [EB/OL]. https：//www.whocc.no/atc_ddd_index/2016-12-20/2017-10-31
[3] 国家卫生计生委办公厅.抗菌药物临床应用指导原则[S].2015.
[4] 成人支气管扩张症诊治专家共识编写组.成人支气管扩张症诊治专家共识[J].中国结核和呼吸杂志，2012，35（7）：485-492.
[5] Levey AS，Coresh J，Balk E，et al. National Kidney Foundation Practice Guidelines for Chronic Kidney Disease： Evaluation，Classification，and Stratification [J]. Annals of Internal Medicine，2003，139（2）：137-149.
[6] Hanberger H，Edlund C，Furebring M，et al. Rational use of aminoglycosides--review and recommendations by the Swedish Reference Group for Antibiotics（SRGA）[J]. Scand J Infect Dis，2013，45（3）：161-175.
[7] 齐嵘.对阿米卡星在临床应用中出现的不良反应的探讨[J].中国现代药物应用，2015，9（4）：73-74.
[8] 李虎，杨春辉，薛杨勇，等.雾化吸入阿米卡星治疗铜绿假单胞菌引起的呼吸机相关性肺炎的临床观察[J].内科急危重症，2016，22（5）：335-337.
[9] 童凯.雾化吸入阿米卡星治疗呼吸机相关性肺炎的临床疗效和安全性[J].临床肺科杂志，2016，21（10）：1862-1865.
[10] 李依，邓磊.阿米卡星不同给药方式治疗呼吸机相关性肺炎的临床观察[J].中国药房，2016，27（27）：3780-3782.
[11] Olivier KN，Shaw PA，Glaser TS，et al. Inhaled amikacin for treatment of refractory pulmonary nontuberculous mycobacterial disease [J]. Ann Am Thorac Soc，2014，11（1）：30-35.
[12] Wong G，Sime FB，Lipman J. How do we use therapeutic drug monitoring to improve outcomes from severe infections in critically ill patients? [J]. BMC Infect Dis，2014， 14：288.
[13] Jenkins A，Thomson AH，Brown NM，et al. Amikacin use and therapeutic drug monitoring in adults：do dose regimens and drug exposures affect either outcome or adverse events? A systematic review [J]. J Antimicrob Chemother，2016，71（71）：2754-2759.
[14] Ezquer-Garin C，Escuder-Gilabert L，Martín-Biosca Y，et al. Fit-for-purpose chromatographic method for the determination of amikacin in human plasma for the dosage control of patients [J]. Talanta，2016，150：510-515.
[15] Agence francaise de sécurité sanitaire des produits de santé. Update on good use of injectable aminoglycosides，gentamycin，tobramycin，netilmicin，amikacin. Pharmacological properties，indications，dosage，and mode of administration，treatment monitoring [J]. Med Mal Infect，2012，42（7）：301-308.
[16] Munckhof WJ，Lindsay Grayson M，Turnidge JD. A meta-analysis of studies on the safety and efficacy of aminoglycosides given either once daily or as divided doses [J]. J Antimicrob Chemother，1996，37（4）：645-653.
[17] Verpooten GA，Giuliano RA，Verbist L，et al. Once-daily dosing decreases renal accumulation of gentamicin and netilmicin [J]. Clin Pharmacol Ther，1989，45（1）：22-27.
[18] Wargo KA，Edwards JD. Aminoglycoside-induced nephrotoxicity [J]. Journal Pharm Pract，2014，27（6）：573.
[19] Fraisse T，Gras aygon C，Paccalin M，et al. Aminoglycosides use in patients over 75 years old [J]. Age Ageing，2014， 43（5）：676-681.
[20] Xie J，Talaska AE，Schacht J. New developments in aminoglycoside therapy and ototoxicity [J]. Hear Res，2011，281（1/2）：28-37.
2018, Vol. 15 
京公网安备 11010502046598号