Factors Influencing Peak Concentrations of Arbekacin in Patients

Arbekacin sulfate (ABK),an aminoglycoside antibiotic agent,is widely used for the treatment of patients infected with methicillin-resistant Staphylococcus aureus (MRSA).Since efficacy and safety depend on its peak and trough concentrations,respectively,therapeutic drug monitoring (TDM) is recommended to ensure the proper use of ABK.However,ABK peak concentrations have often been lower than expected making dose setting difficult in the early stage of treatment.The aim of this study was to determine factors influencing ABK peak concentrations.We first performed multiple regression analysis on the peak concentration to dose ratio as the dependent variable.The results showed that infusion time,creatinine clearance,body mass index,serum albumin and chronic heart failure significantly influenced the peak concentration to dose ratio.We also investigated the effects of these factors on pharmacokinetic parameters estimated by the Bayesian method finding that creatinine clearance,daily volume of infusion and serum albumin were factors influencing terminal half-life,body mass index,serum albumin and chronic heart failure were factors influencing distribution volume.In conclusion,our findings suggest that factors influencing distribution volume are important in setting doses of ABK.