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Titolo:
A simple tool for monitoring nebulized amikacin treatments based on a single urine assay
Autore:
Faurisson, F; Delatour, F; Jelazko, P;
Indirizzi:
Hop Bichat Claude Bernard, INSERM 99 33, F-75877 Paris 18, France Hop Bichat Claude Bernard Paris France 18 9 33, F-75877 Paris 18, France
Titolo Testata:
JOURNAL OF AEROSOL MEDICINE-DEPOSITION CLEARANCE AND EFFECTS IN THE LUNG
fascicolo: 1, volume: 14, anno: 2001,
pagine: 73 - 81
SICI:
0894-2684(200121)14:1<73:ASTFMN>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTIPSEUDOMONAL ANTIBIOTIC-THERAPY; CYSTIC-FIBROSIS; PSEUDOMONAS-AERUGINOSA; AEROSOLIZED TOBRAMYCIN; RESPIRATORY-TRACT; JET NEBULIZER; DEPOSITION; COLONIZATION; PERFORMANCE; INFECTION;
Keywords:
inhalation therapy; amikacin; cystic fibrosis; drug monitoring;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Faurisson, F Hop Bichat Claude Bernard, INSERM 99 33, 170 Blvd Ney, F-75877 Paris 18, France Hop Bichat Claude Bernard 170 Blvd Ney Paris France 18 rance
Citazione:
F. Faurisson et al., "A simple tool for monitoring nebulized amikacin treatments based on a single urine assay", J AEROSOL M, 14(1), 2001, pp. 73-81

Abstract

Aerosolized aminoglycosides have demonstrated their efficacy in the treatment of P. aeruginosa pneumonia in cystic fibrosis (CF) patients. There is wide interpatient variability in the deposited and systemic drug doses that depend on both the nebulization and inhalation conditions and result in a risk of inefficacy or toxicity. We have developed a tool to provide a simplemethod for individual dose monitoring by estimating the total quantity of amikacin excreted, which corresponds to the dose absorbed systemically. It is based on a single urine assay. Thirty-seven urinary pharmacokinetic timecourses in healthy volunteers (groups A and B) or in CF patients (groups Cand D) were used. The rules for extrapolating the total dose excreted on the basis of 6-, 8-, 10-, and 12-h urine samples, were determined from groupA. The accuracy of these rules was then tested in the other three groups. The total amount excreted was poorly predictable, with a coefficient of variation (CV) of 36 and 30% in the healthy volunteers, and of 48 and 82% in the CF group, whereas the CV of the estimated amount, based on 8- to 12-h samples, was only 10-15% in the healthy volunteers and 4-8% in the CF patients. Collecting a single sample over an 8- to 12-h period requires overnight sampling. The very low circadian variations in renal function, ranging from-2% to +5%, demonstrated the absence of any significant bias resulting from overnight sampling. A single urine assay can therefore be proposed as a simple, noninvasive, low cost, and reliable method for the clinical monitoring of nebulized amikacin in CF patients. Further studies are needed before this method can be extended to aerosol treatments with other aminoglycosides.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 01:58:41