PMID- 19793633
OWN - NLM
STAT- MEDLINE
DCOM- 20100630
LR  - 20131121
IS  - 1769-6690 (Electronic)
IS  - 0399-077X (Linking)
VI  - 40
IP  - 2
DP  - 2010 Feb
TI  - [Monitoring aminoglycosides in an Intensive Care Unit].
PG  - 94-9
LID - 10.1016/j.medmal.2009.08.011 [doi]
AB  - OBJECTIVES: This monocentric, observational and retrospective survey was 
      performed to check the appropriateness between aminoglycoside prescriptions and 
      inhibitor quotient to be reached, in Intensive Care Unit (ICU) patients. We 
      identified variability factors for aminoglycoside plasmatic concentrations at 
      peak such as standardized index of gravity (IGS2 scale), age, sex, weight, and 
      severity of sepsis. PATIENTS AND METHOD: Eighty-seven ICU patients received an 
      antibiotic combination mandatorily including an aminoglycoside (amikacin or 
      gentamicin) as curative treatment for a severe infection. Prescribed dosages were 
      15mg/kg for amikacin and 5mg/kg for gentamicin. The maximal concentration (Cmax) 
      and minimal inhibiting concentration (MIC) of involved bacteria were recorded. 
      The aminoglycoside ratio Cmax/MIC, called inhibitor quotient, was determined. The 
      inhibitor quotient was considered efficient when superior to 10. The Cmax for 
      aminoglycoside first peak was also compared with the theoretical Cmax to be 
      reached. RESULTS: In the aminoglycoside Cmax, 50.3% were efficient (59.6% for 
      amikacin Cmax and 38.9% for gentamicin Cmax). In 46% of the cases, the inhibitor 
      quotient was efficient; 12.6% of Cmax reached the theoretical Cmax. Factors 
      identified as negatively interacting with biological efficiency were: 
      Gram-positive bacteria or anaerobic bacteria infections and planned surgery. 
      CONCLUSION: In the inhibitor quotients, 49.7% were at inefficient rates, even 
      when the recommended aminoglycoside dosage for was given. Therefore, dose and 
      administration should be updated.
FAU - Commandeur, D
AU  - Commandeur D
AD  - Departement anesthesie-reanimation-urgences, hopital d'instruction des armees 
      Clermont-Tonnerre, rue du Colonel-Fontferrier, Brest-Armees, France. 
      diane.commandeur@wanadoo.fr
FAU - Eyrieux, S
AU  - Eyrieux S
FAU - Le Noel, A
AU  - Le Noel A
FAU - Nguyen, V B
AU  - Nguyen VB
FAU - Giacardi, C
AU  - Giacardi C
FAU - Danguy des Deserts, M
AU  - Danguy des Deserts M
FAU - Buguet-Brown, M-L
AU  - Buguet-Brown ML
FAU - Drouillard, I
AU  - Drouillard I
LA  - fre
PT  - English Abstract
PT  - Journal Article
TT  - Monitorage des aminosides en reanimation.
DEP - 20090929
PL  - France
TA  - Med Mal Infect
JT  - Medecine et maladies infectieuses
JID - 0311416
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Gentamicins)
RN  - 84319SGC3C (Amikacin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Amikacin/*blood/therapeutic use
MH  - Anti-Bacterial Agents/*blood/therapeutic use
MH  - *Drug Monitoring
MH  - Female
MH  - Gentamicins/*blood/therapeutic use
MH  - Humans
MH  - *Intensive Care Units
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Young Adult
EDAT- 2009/10/02 06:00
MHDA- 2010/07/01 06:00
CRDT- 2009/10/02 06:00
PHST- 2009/02/15 00:00 [received]
PHST- 2009/06/23 00:00 [revised]
PHST- 2009/08/31 00:00 [accepted]
PHST- 2009/10/02 06:00 [entrez]
PHST- 2009/10/02 06:00 [pubmed]
PHST- 2010/07/01 06:00 [medline]
AID - S0399-077X(09)00230-3 [pii]
AID - 10.1016/j.medmal.2009.08.011 [doi]
PST - ppublish
SO  - Med Mal Infect. 2010 Feb;40(2):94-9. doi: 10.1016/j.medmal.2009.08.011. Epub 2009 
      Sep 29.