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Free Content Once-daily dosing of amikacin for treatment of Mycobacterium abscessus lung disease

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SETTING: Tertiary referral centre, Samsung Medical Center, South Korea.

OBJECTIVE: To evaluate the pharmacokinetic parameters and toxicities of once-daily amikacin (AMK) dosing for lung disease due to Mycobacterium abscessus.

DESIGN: A retrospective review of 48 patients with M. abscessus lung disease who received once-daily AMK for 4 weeks between January 2012 and June 2015.

RESULTS: With a starting dose of 15 mg/kg/day and adjustment of AMK dose according to the peak serum level (Cmax), the Cmax target of 55–65 μg/ml was achieved in 31.3% (15/48) of patients in the first week, 68.8% (33/48) in week 2, 91.7% (44/48) in week 3 and 95.8% (46/48) in week 4. Transient nephrotoxicity developed in 6.3% (3/48) of patients and ototoxicity in 25.0% (6/24), which was determined by audiogram as hearing loss, asymptomatic in five patients and tinnitus in one. Multivariate analysis revealed that the highest drug concentration 12 h after administration was significantly associated with the development of toxicities (adjusted odds ratio 1.862, P = 0.047).

CONCLUSION: Our results suggest that once-daily AMK for 4 weeks with a target Cmax of 55–65 μg/ml can be used in patients with M. abscessus lung disease, with careful monitoring of toxicity.
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Keywords: AMK; M. abscessus; nephrotoxicity; non-tuberculous mycobacteria; ototoxicity

Document Type: Research Article

Affiliations: 1: Division of Pulmonary and Critical Care Medicine, Department of Medicine 2: Department of Pharmaceutical Services 3: Department of Laboratory Medicine and Genetics 4: Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 5: Department of Microbiology, Yonsei University College of Medicine, Seoul, South Korea

Publication date: 01 July 2017

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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