Evaluation of renal and auditory functions in children, in relation to the dosage regimen (once- daily versus multiple-daily) of amikacin
Maria Gołębiowska, Jarosław Wlazłowski, Jarosław Andrzejewski
Med Sci Monit 1999; 5(2): CR280-284
The aim of this study was to evaluate side effects of amikacin administration in the treatment of infants and small children, in relation to its dosage. The study group comprised 49 children aged between 2 months and 3 years, who received amikacin due to severe infections - once (21), or twice (three times) a day (28 children). We performed urinalysis as well as serum urea, creatinine and endogenous creatinine clearance levels in each patient before and following treatment completion (Schwartz method). Moreover, we assessed the urine concentration of β2 microglobulin in 30 children (14 from group A and 16 from group B). Hearing was evaluated in 31 patients, including 15 from group A and 16 from group B, by means of subjective testing methods (ABR, SOAE, TOAE). Renal function compromise defined as an increase of serum creatinine by more than 44.2 µl/L compared with primary values was not observed in any of the children. The concentration of β2 microglobulin was significantly higher before treatment and decreased during the course of treatment regardless of amikacin dosage. We noted heavy bilateral hearing impairment in one child. The patient had received aminoglycosides once a day. Due to the coexistence of various risk factors it was impossible to establish whether the hearing impairment was a result of aminoglycoside activity on internal ear cells. In conclusion, the administration of amikacin once a day does not increase the risk of side effects.
Keywords: ototoxicity, nephrotoxicity, dosage, children, amikacin