Disclaimer

Amikacin dose selection has been created for personal use only. The use of any result generated by this application is in any case the sole risk and responsibility of the user. Therapeutic decision should not solely rely on this applicatoin as the information provided by this tool does not replace clinical judgement. Amikacin dose selection has been validated and realeased in January 2019, there is no guarantee for the accuracy of the provided results. When using Amikacin dose selection you automatically agree with this disclaimer and the legal notices.

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PK model

A one-compartment model with linear elimination best describe amikacin time-concentration data. Serum albumin and total bodyweight were included in the amikacin clearance. Concomitant administration of vancomycin and CKD-EPI were included in amikacin clearance. Additional details of the PopPK model development and evaluation are available in the following publications: Perez-Blanco JS, Saez Fernandez EM, Lanao J, Calvo MV, Martin-Suarez A. Amikacin initial dosage in patients with hypoalbuminemia: an interactive tool based on a population pharmacokinetic approach. 2020. Journal of Antimicrobial Chemotherapy, DOI: 10.1093/jac/dkaa158

CL(L/h) = 0.525 + 4.78 x (CKD-EPI/98) x (0.77 x VANCOMYCIN)

V(L) = 26.3 x (ALBUMIN/2.9)^-0.51 x [1 + 0.006 x (WGT - 70)]

Where CKD-EPI is the renal function calculated with CKD-EPI equation and expressed in mL/min (deindexed); VANCOMYCIN is 0 or 1 in abcense or co-medication with vancomycin, respectively; ALBUMIN is expresed in g/dL; WGT is total bodyweight in kg.

Important considerations which must be taking into account when applying AMKdose:

• PopPK model was developed in adults with no acute renal impairment (<30 mL/min)
• PKPD modifications in presence of drugs which may affect amikacin PK (i.e. meropenem, piperacillin, tigecycline, quinolone, vasoactives, etc.) were not considered in the PK model development and must be taking into account in the clinical practice
• AMKdose has been designed as a useful tool for INITIAL dose recommendation; individual patient dosage optimization may be required based on following therapeutic drug monitoring and/or clinical response
• Total bodyweight (TBW) was the best size descriptor of amikacin PK; however, PK alterations in morbid obesity was not studied andherefore initial dose recommendation on this population (based on TBW) may considered carefully
• PKPD cut-offs and dose selection algorithm implemented has been chosen based on previous knowledge, but it has not been quantitatively evaluated in the literature
• AMKdose has not been clinically validated

Salamanca, 23th July 2020

About us

We are a group of pharmacometrics who work closely with the clinical teams to improve the current treatments.

You can find us at the Pharmaceutical Science Department of the University of Salamanca (Spain).

We are also part of the Clinic and experimental pharmacokinetics group of the Biomedicine research institute of Salamanca, IBSAL.

Jonás Samuel Pérez-Blanco

email | Diarium | ORCID

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Don´t hesitate to send us an email to jsperez@usal.es.