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dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorAznar Ruiz de Alegria, Maria Luisa
dc.contributor.authorMarras, Theodore K
dc.contributor.authorElshal, Ahmed Said
dc.contributor.authorMehrabi, Mahtab
dc.contributor.authorBrode, Sarah K
dc.date.accessioned2019-08-01T11:55:17Z
dc.date.available2019-08-01T11:55:17Z
dc.date.issued2019-06-03
dc.identifier.citationAznar ML, Marras TK, Elshal AS, Mehrabi M, Brode SK. Safety and effectiveness of low-dose amikacin in nontuberculous mycobacterial pulmonary disease treated in Toronto, Canada. BMC Pharmacol Toxicol. 2019;20(1):37.
dc.identifier.issn2050-6511
dc.identifier.urihttp://hdl.handle.net/11351/4232
dc.descriptionAmikacin; NTM lung disease; Nontuberculous mycobacteria
dc.description.abstractBACKGROUND: Treatment guidelines suggest either a low-dose or high-dose approach when prescribing amikacin for nontuberculous mycobacterial pulmonary disease (NTM PD), but data supporting the low-dose approach are limited. The purpose of this study was to describe the safety and efficacy of the use of a low-dose of intravenous amikacin in a cohort of patients with NTM PD. METHODS: We retrospectively reviewed all patients with NTM PD who received amikacin at our institution between July 1, 2003 and February 28, 2017. Demographics, clinical, microbiological and radiological data, indication and dose of amikacin, and adverse drug effects were recorded. RESULTS: A total of 107 patients received a regimen containing amikacin for a median (IQR) of 7 (4-11) months. Seventy (65.4%) were female and the mean age (SD) was 58.3 (14.9) years. Amikacin was started at a median dose of 9.9 (2.5) mg/kg/day. Ototoxicity was observed in 30/77 (39%) patients and it was related to female sex (OR 4.96, 95%CI 1.24-19.87), and total dose of amikacin per bodyweight (OR 1.62, 95%CI 1.08-2.43). Patients of East Asian ethnicity were less likely to develop ototoxicity (0.24, 95%CI 0.06-0.95). Out of 96 patients who received amikacin for more than 3 months, 65 (67.7%) experienced symptom improvement and 30/62 (49.2%) converted their sputum to culture negative within a year. CONCLUSIONS: Patients with NTM PD treated with low-dose intravenous amikacin frequently developed ototoxicity, which was associated with female sex, and total dose of amikacin per bodyweight. Physicians should carefully consider dose, treatment duration, and long term prognosis in balancing risks and benefits of intravenous amikacin in NTM PD.
dc.language.isoeng
dc.publisherBMC
dc.relation.ispartofseriesBMC Pharmacology and Toxicology;20(1)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectMicobacteriosis - Quimioteràpia - Toronto
dc.subjectAminoglucòsids
dc.subjectMedicaments - Administració
dc.subject.meshMycobacterium Infections, Nontuberculous
dc.subject.mesh/drug therapy
dc.subject.meshAmikacin
dc.subject.mesh/administration & dosage
dc.subject.meshToronto
dc.titleSafety and effectiveness of low-dose amikacin in nontuberculous mycobacterial pulmonary disease treated in Toronto, Canada
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1186/s40360-019-0302-1
dc.subject.decsmicobacterias no tuberculosas
dc.subject.decs/tratamiento farmacológico
dc.subject.decsamicacina
dc.subject.decs/administración & dosificación
dc.subject.decsToronto
dc.relation.publishversionhttps://bmcpharmacoltoxicol.biomedcentral.com/articles/10.1186/s40360-019-0302-1
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Aznar ML] Joint Division of Respirology, Department of Medicine, University Health Network Toronto, Canada. Sinai Health System, Toronto, Canada. Servei de Medicina, Hospital Universitari Vall d'Hebron, Barcelona, Spain. PROSICS Barcelona, Barcelona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain. [Marras TK, Mehrabi M] Joint Division of Respirology, Department of Medicine, University Health Network Toronto, Canada. Sinai Health System, Toronto, Canada. [Elshal AS] Joint Division of Respirology, Department of Medicine, University Health Network Toronto, Canada. Sinai Health System, Toronto, Canada. Gastroenterology Department, National Hepatology and Tropical Medicine Institute, Cairo, Egypt. [Brode SK] Joint Division of Respirology, Department of Medicine, University Health Network Toronto, Canada. Sinai Health System, Toronto, Canada. West Park Healthcare Centre, Toronto, Canada.
dc.identifier.pmid31159865
dc.identifier.wosWOS:000470115100001
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


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