Impact of duration of infusion on estimated blood amikacin levels: A study at the Central General Hospital in Yogyakarta, Indonesia

The duration of infusion may influence the plasma drug level, thereby influencing effectiveness and toxicity. Intravenous amikacin (AMK) should not be given as a bolus. Instead, it is recommended to be administered via intermittent infusion over 30–60 minutes. This study aimed to determine differences in the estimated pharmacokinetic (PK)/pharmacodynamic parameters of AMK when administered via 30- versus 60-minute infusions, as well as the relationship with outcomes and toxicity. The data for this study were gathered from the medical records of adult inpatients treated with AMK at Dr. Sardjito Hospital in Yogyakarta. Due to the lack of therapeutic drug monitoring, blood AMK levels were estimated using a pharmacokinetic formula. The results demonstrated that the duration of AMK infusion had an impact on the estimated AMK levels (Cmax, Cmin, and maximum concentration/minimum inhibitory concentration ratio). Estimated AMK Cmax and Cmin showed a significant correlation with mortality and signs of toxicity, and Cmin of <2.5 mg/kgBW/day had a significant difference in clinical outcomes. AMK administered via 30-minute infusion results in faster and higher estimated Cmax; however, administration of AMK by 60-minute infusion may be more appropriate to decrease mortality rate while posing the same toxicity risk. Further research based on actual blood levels is needed. © 2024 Esti Dyah Utami et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).