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Impact of a high loading dose of amikacin in patients with severe sepsis or septic shock

Overview of attention for article published in Annals of Intensive Care, November 2016
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (51st percentile)
  • Above-average Attention Score compared to outputs of the same age and source (59th percentile)

Mentioned by

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4 tweeters

Citations

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23 Dimensions

Readers on

mendeley
49 Mendeley
Title
Impact of a high loading dose of amikacin in patients with severe sepsis or septic shock
Published in
Annals of Intensive Care, November 2016
DOI 10.1186/s13613-016-0211-z
Pubmed ID
Authors

Nicolas Allou, Astrid Bouteau, Jérôme Allyn, Aurélie Snauwaert, Dorothée Valance, Julien Jabot, Bruno Bouchet, Richard Galliot, Laure Corradi, Philippe Montravers, Pascal Augustin

Abstract

The therapeutic effect of aminoglycosides is highest and optimal when the peak plasma concentration (C max)/minimal inhibitory concentration (MIC) ratio is between 8 and 10. The French guidelines recommend to use high doses of aminoglycosides for empiric antibiotic therapy in patients suffering from severe sepsis or septic shock. In clinical practice, the recommended target is an amikacin C max between 60 and 80 mg/L, which corresponds to approximately 8 times the MIC breakpoint, as defined by the European Committee on Antimicrobial Susceptibility Testing. The aim of this study was to assess the incidence and impact on mortality of an amikacin concentration between 60 and 80 mg/L in patients suffering from severe sepsis or septic shock. This was a prospective observational cohort study conducted in two intensive care units (ICU). Patients receiving amikacin at a loading dose of 30 mg/kg for severe sepsis or septic shock were enrolled in the cohort. The target C max for amikacin was between 60 and 80 mg/L, as recommended by French guidelines (i.e. C max/MIC breakpoint = 8-10). Over the study period, the amikacin C max was <60 mg/L, between 60 and 80 mg/L, and >80 mg/L in 20 (18.2%), 46 (41.8%) and 44 (40%) of the 110 selected patients, respectively. Mortality rate was 40, 28.3 and 56.8% in the groups of patients with C max < 60 mg/L, 60 mg/L < C max < 80 mg/L and C max > 80 mg/L, respectively. Following multivariate analysis, mortality rate was significantly lower in the group of patients with amikacin C max between 60 and 80 mg/L than in the group of patients with amikacin C max > 80 mg/L (P = 0.004). The multivariate analysis also revealed that the factors independently associated with a higher in-ICU mortality rate were age (P = 0.02) and norepinephrine dose (P = 0.0001). With a loading dose of 30 mg/kg of amikacin, concentration was potentially suboptimal (C max < 60 mg/L) in only 18.2% of patients. The pharmacodynamic target (60 mg/L < C max < 80 mg/L) recommended by French guidelines was reached in 41.8% of patients and was associated with reduced in-ICU mortality. But amikacin overexposure (i.e. C max > 80 mg/L) was frequent and potentially associated with increased mortality.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 49 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 49 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 9 18%
Student > Master 6 12%
Researcher 6 12%
Other 5 10%
Student > Ph. D. Student 4 8%
Other 9 18%
Unknown 10 20%
Readers by discipline Count As %
Medicine and Dentistry 19 39%
Pharmacology, Toxicology and Pharmaceutical Science 17 35%
Biochemistry, Genetics and Molecular Biology 1 2%
Veterinary Science and Veterinary Medicine 1 2%
Nursing and Health Professions 1 2%
Other 1 2%
Unknown 9 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 January 2017.
All research outputs
#6,787,890
of 12,075,223 outputs
Outputs from Annals of Intensive Care
#276
of 469 outputs
Outputs of similar age
#119,704
of 256,972 outputs
Outputs of similar age from Annals of Intensive Care
#11
of 27 outputs
Altmetric has tracked 12,075,223 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 469 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one is in the 39th percentile – i.e., 39% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 256,972 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 51% of its contemporaries.
We're also able to compare this research output to 27 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 59% of its contemporaries.