Relation between pharmacokinetics of amikacin sulfate and sepsis score in clinically normal and hospitalized neonatal foals.

The researchers investigated the impact of sepsis and serum creatinine levels on the pharmacokinetics of amikacin sulfate in both healthy and hospitalized neonatal foals within the first week of life. They found that in hospitalized foals, higher sepsis scores and serum creatinine levels correlated with reduced clearance of the drug, suggesting that these could serve as effective indicators of altered drug distribution.

Study Objectives

• The primary objective of this study was to determine the pharmacokinetics of amikacin sulfate in both healthy and hospitalized foals during their first week of life. Pharmacokinetics involves the study of how a drug is absorbed, distributed, metabolized, and excreted by the body.
• The researchers also aimed to clarify the relationship between sepsis scores, serum creatinine concentrations, and the pharmacokinetic parameters of the drug in question.

Methods

• To understand the drug’s behavior in the body, the researchers administered amikacin sulfate intravenously to both groups of foals and tracked its distribution over time.
• Sepsis scores — a measure of the body’s response to infection — and serum creatinine concentration — a marker of kidney function — were monitored and compared with the pharmacokinetics of the drug.

Findings

• In healthy foals, the researchers did not find any significant differences in sepsis scores, serum creatinine concentrations, and the pharmacokinetic values of amikacin between foals aged 1 to 3 days and those aged 4 to 7 days.
• In contrast, among the hospitalized foals, the sepsis scores and serum creatinine concentrations were higher than in healthy foals.
• Furthermore, these hospitalized foals exhibited increased area under the curve and mean residence time — both pharmacokinetic parameters that reflect the total exposure of the body to the drug and how long the drug stays in the body, respectively.
• Crucially, the total clearance of the drug was decreased in hospitalized foals compared to healthy ones. This implies that the drug is eliminated from the body more slowly in the former group.
• Finally, the researchers confirmed an inverse correlation between sepsis scores and serum creatinine concentration and the clearance of amikacin, suggesting that these two metrics could be used to predict variations in drug distribution.

Implications

• This study enhances our understanding of how illness, such as sepsis, and the function of the kidneys can affect drug behavior, especially for amikacin sulfate in neonatal foals.
• The findings suggest that monitoring sepsis scores and serum creatinine concentration could serve as a practical means for healthcare providers to adjust dosage plans and treatment strategies, alternatively predict how a drug would act in the body under different physiological conditions.