A COMPARISON OF 2 AMIKACIN DOSING REGIMENS IN PEDIATRIC SURGICAL PATIENTS

This investigation aimed to compare the efficacy and toxicity of two a mikacin dosing regimens in seriously ill paediatric surgical patients. Children (0.6-12 years old) received amikacin intravenously either on ce daily (15 mg/kg, n = 27) or twice daily (7.5 mg/kg, n = 21). Concom itant medication was given as prescribed. Mean (SD) peak serum amikaci n levels were significantly different (p<0.05) between the once and tw ice daily groups (37.7 (6.9) mg/l and 19.5 (3.7) mg/l, respectively). Cumulative dose and duration of therapy were also significantly higher in the once-daily group. Regimen efficacy (favourable, unfavourable o r indeterminate outcome) was assessed by patient temperatures, clinica l improvement and white cell counts. Serum creatinine measurements and post-therapy, pure tone air conduction audiometry assessed nephro-and ototoxicity, respectively. No statistically significant differences w ere found between the groups in terms of outcome (18/24 and 22/25 pati ents in the once-and twice-daily groups had favourable outcomes; there were no unfavourable outcomes), nephrotoxicity (none of the patients assessed developed nephrotoxicity) or ototoxicity (2/20 and 5/20 patie nts, respectively, had mild high frequency hearing deficits which were predominantly unilateral and reversible). Although the regimens were similar in this study, other investigations will further clarify the o ptimal dosing approach in paediatric patients.