Pharmacokinetics of Amikacin in Serum and in Tissue Contiguous with Pressure Sores in Humans with Spinal Cord Injury

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1990 · DOI: · Published: July 1, 1990

Spinal Cord Injury Pharmacology Healthcare

Simple Explanation

This study investigates how the antibiotic amikacin behaves in the bodies of patients with spinal cord injuries, specifically focusing on its concentration in tissues near pressure sores. The research reveals that amikacin's movement in these tissues doesn't directly mirror its levels in the blood and isn't accurately predicted by standard pharmacokinetic models. The study emphasizes the need for methods that can accurately measure amikacin levels and protein binding in tissue fluid to make informed decisions about antibiotic treatment for these patients.

Study Duration

Not specified

Participants

12 nonobese male volunteers (5 tetraplegic, 7 paraplegic)

Evidence Level

Not specified

Key Findings

1
Amikacin disposition in the tissue contiguous with pressure sores appears to be governed by simultaneous first-order and capacity-limited pharmacokinetic behavior.
2
Amikacin disposition in IF proceeded without a simple relationship to amikacin concentrations in serum.
3
The pharmacokinetic behavior of amikacin in IF and serum was best simulated with a two-compartment open model using simultaneous first-order and capacity-limited disposition kinetics.

Research Summary

The study analyzes amikacin concentration and protein binding in interstitial fluid (IF) near pressure sores in SCI patients, revealing that amikacin disposition in tissue is governed by simultaneous first-order and capacity-limited pharmacokinetics. It highlights that amikacin levels in IF do not directly correlate with serum concentrations and cannot be accurately simulated by linear models. The research suggests that optimal amikacin use in SCI patients with infected pressure sores requires methods that quantify amikacin concentration and protein binding in IF and incorporate models simulating nonlinear and linear disposition processes.

Practical Implications

Optimized Dosing

Individualized dosing regimens should be developed based on the pharmacokinetic behavior of amikacin in both serum and interstitial fluid to maximize effectiveness and minimize toxicity.

Improved Monitoring

Clinical monitoring should include assessment of amikacin concentrations in interstitial fluid, not just serum, to better understand drug exposure at the site of infection.

Model Refinement

Pharmacokinetic models should be refined to incorporate nonlinear disposition processes to accurately predict amikacin behavior in SCI patients with pressure sores.

Pharmacokinetics of Amikacin in Serum and in Tissue Contiguous with Pressure Sores in Humans with Spinal Cord Injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Optimized Dosing

Improved Monitoring

Model Refinement

Study Limitations

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Pharmacokinetics of Amikacin in Serum and in Tissue Contiguous with Pressure Sores in Humans with Spinal Cord Injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Optimized Dosing

Improved Monitoring

Model Refinement

Study Limitations

Your Feedback

Was this summary helpful?