Creatinine clearance estimation in the extremely elderly subjects

Hirayama, S.; Kikuchi, Reiko; Inoue, Shin‐ichiro; Tsukahara, Daisuke; Suemitsu, Yumi; Kobayashi, Yoshio; Sugiyama, Yoichi; Hasegawa, Hiroshi; Kouzaki, Koichi; Inoue, Gosuke; Toba, Kenji

doi:10.3143/geriatrics.44.90

Cited by 2 publications

(1 citation statement)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…All clinical data were extracted from the electronic health records through structured chart review. Demographic data at least 3 days before amikacin treatment started were collected, including gender, age, total weight, lean body weight (LBW), body mass index (BMI), ideal body weight (IBW), albumin, serum creatinine, CCr estimated according to the Cockcroft-Gault equation [45] since the Cockcroft-Gault equation is the best predictive equation of creatinine clearance for elderly patients [46], aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and total bilirubin. IBW was calculated as follows: IBW = 22 × (height in m) 2 (kg).…”

Section: Data Collectionmentioning

confidence: 99%

Population Pharmacokinetics Analysis of Amikacin Initial Dosing Regimen in Elderly Patients

et al. 2021

View full text Add to dashboard Cite

There are limited data of amikacin pharmacokinetics (PK) in the elderly population. Hence, we aimed to describe the population PK of amikacin in elderly patients (>70 years old) and to establish optimized initial dosing regimens. We simulated individual maximum concentrations in plasma (Cmax) and minimal concentrations (Cmin) for several dosing regimens (200–2000 mg every 24, 48, and 72 h) for patients with creatinine clearance (CCr) of 10–90 mL/min and analyzed efficacy (Cmax/minimal inhibitory concentration (MIC) ≥ 8) for MICs of 4, 8, and 16 mg/L and safety (Cmin < 4 mg/L). A one-compartment model best described the data. CCr was the only covariate associated with amikacin clearance. The population PK parameter estimates were 2.25 L/h for clearance and 18.0 L for volume of distribution. Dosing simulations recommended the dosing regimens (1800 mg) with dosing intervals ranging 48–72 h for patients with CCr of 40–90 mL/min based on achievement of both efficacy for the MIC of 8 mg/L and safety. None of the dosing regimens achieved the targets for an MIC of 16 mg/L. We recommend the initial dosing regimen using a nomogram based on CCr for an MIC of ≤8 mg/L in elderly patients with CCr of 40–90 mL/min.

show abstract

Section: Data Collectionmentioning

confidence: 99%