ABSTRACT
Pharmacokinetic analysis was performed on 38 thermally injured children ranging from 3 months to 18 years of age with per cent total body surface area burns (%TBSA) of 17-87%. All patients needed increased dosing requirements for amikacin to maintain therapeutic serum levels. There was a wide variation in the volumes of distribution and an inverse relationship with age, i.e., the volume of distribution tended to be lower in the older children. The results indicate the manufacturer's recommended dose will result in subtherapeutic serum levels and we recommended initial doses of at least 10 mg/kg administered every 6 h. Dosage adjustments using individualized pharmacokinetics should then be performed within 24 h of initiation of therapy. The study documents the importance of dosage individualization for amikacin in the burned child.
Subject(s)
Amikacin/administration & dosage , Burns/metabolism , Adolescent , Age Factors , Amikacin/pharmacokinetics , Amikacin/therapeutic use , Burns/complications , Child , Child, Preschool , Female , Humans , Infant , MaleABSTRACT
A prospective randomized double-blind study evaluated the efficacy of i.v. immune globulin in preventing infectious complications in severely burned patients. Fifty patients were randomized to receive either i.v. immune globulin or placebo. Each group of patients was treated with twice weekly infusions for either 5 weeks or until the patients' wounds were covered. Patients treated with the immune globulin had an immediate correction of their depressed serum IgG levels, however there was no change in the infection or mortality rates. No adverse effects were noted with the immune globulin treatments. One potential weakness of this study was the greater burn surface area and a higher incidence of inhalation injury in adult patients treated with i.v. immune globulin compared to controls.
