Resistance and efficiency of amikacin in critically ill septic children: a cross-sectional study

Background: Therapeutic drug monitoring facilitates the individualiza­tion of amikacin dosing for patients based on pharmacodynamics and pharmacokinetics. Its efficacy is measured by peak serum concentration (Cpeak) / minimum inhibitory concentration (MIC) ratio. This study aims to determine the efficacy of 15 mg/kg/day of amikacin in critically ill septic pediatric patients. Methods: This cross-sectional analytic study involved 25 pediatric critically ill septic patients. All patients received amikacin based on clinical diagnosis and/or culture results. Amikacin Cpeak and MIC were measured. Results: Amikacin Cpeak was not achieved in 44% of the study group, with the MIC being at least 64 mcg/mL, leading to a very low Cpeak/MIC ratio. Conclusion: Critically ill pediatric patients who are administered amikacin require frequent monitoring and dose adjustment to achieve the target level, as subtherapeutic levels may contribute to resistance, while elevated levels are linked to non-oliguric acute kidney injury.