Clinical practice guidelines for therapeutic drug monitoring of arbekacin: A consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring

Kenji Okada, Toshimi Kimura, Hiroshige Mikamo, Kei Kasahara, Masafumi Seki, Shunji Takakura, Issei Tokimatsu, Norio Ohmagari, Yoshiko Takahashi, Kazuaki Matsumoto, Masahiro Igarashi, Masahiro Kobayashi, Yukihiro Hamada, Takahiro Mochizuki, Masao Kimura, Yoshifumi Nishi, Yusuke Tanigawara, Yoshio Takesue

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Abstract

Arbekacin (ABK) was approved and widely used in Japan for treatment of patients infected with MRSA, and TDM was introduced in clinical practice. The Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring decided to develop a clinical practice guidelines for TDM of ABK for the following reasons. First, although the daily dose of 150e200 mg was approved in Japan, recent PKPD studies revealed that higher serum concentration is required to achieve better clinical efficacy and several findings concerning the usefulness of higher dosage regimen have obtained recently. Second, although maximal concentrations that obtained immediately after the end of administration (Cmax) was generally adopted, the serum concentration at 1 h after initiation of administration [peak serum concentration (Cpeak)] proved to be more suitable as an efficacy indicator of aminoglycosides. Lastly, as ABK is approved only in Japan, no international practice guideline for TDM has not been available in ABK to date. This guideline evaluated the scientific data associated with serum ABK monitoring and provided recommendations based on the available evidence. Potential limitations of this guideline, however, include the findings that few prospective clinical trials of TDM of ABK are available in the treatment of MRSAinfections and that most of the published literature describes observational studies.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalJournal of Infection and Chemotherapy
Volume20
Issue number1
DOIs
Publication statusPublished - 2014 Jan

Keywords

  • Arbekacin
  • Guideline
  • MRSA
  • Therapeutic drug monitoring

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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    Okada, K., Kimura, T., Mikamo, H., Kasahara, K., Seki, M., Takakura, S., Tokimatsu, I., Ohmagari, N., Takahashi, Y., Matsumoto, K., Igarashi, M., Kobayashi, M., Hamada, Y., Mochizuki, T., Kimura, M., Nishi, Y., Tanigawara, Y., & Takesue, Y. (2014). Clinical practice guidelines for therapeutic drug monitoring of arbekacin: A consensus review of the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring. Journal of Infection and Chemotherapy, 20(1), 1-5. https://doi.org/10.1016/j.jiac.2013.08.008