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[Pharmacokinetics of amikacin in infants and children]
1Department of Pediatrics, National Sanatorium Dohoku Hospital.
Insights
Amikacin (AMK) clearance accelerates in children as they age, particularly during the neonatal period. Peak serum levels also increase with age, indicating altered pharmacokinetics in pediatric patients.
Area of Science:
- Pharmacokinetics
- Pediatric Pharmacology
- Drug Metabolism
Context:
- Bacterial infections are a significant concern in pediatric populations.
- Amikacin (AMK) is an antibiotic used to treat bacterial infections.
- Understanding drug pharmacokinetics in children is crucial for effective treatment.
Purpose:
- To investigate the pharmacokinetic profile of amikacin (AMK) in pediatric patients.
- To determine how age affects amikacin's half-life, volume of distribution, and peak serum levels.
- To provide data for optimizing amikacin dosing in children.
Summary:
- This study analyzed amikacin pharmacokinetics in 21 children aged 41 hours to 12 years.
- Amikacin half-life significantly shortened with age, most notably in neonates, stabilizing after 6 months.
- Volume of distribution decreased with age, while peak level-dose ratio increased, suggesting age-dependent changes in drug disposition.
Impact:
- Findings highlight critical age-related pharmacokinetic changes in amikacin.
- Results can inform more precise amikacin dosing strategies for pediatric patients.
- Improved dosing may enhance therapeutic efficacy and minimize toxicity in children.
Abstract:
Twenty-one children, from 41 hours to 12 years of age, were given amikacin (AMK) for suspected bacterial infections. In the 41 hours old newborn infant, the half-life of AMK was 6.9 hours. As infants' ages increase, half-lives of AMK became shorter. The trend toward a shorter half-life in an older child was the most marked during neonatal period. At an age of 7 days, the half-life was shorter than 3 hours. In infants exceeding 6 months of age, ages did not make differences in the length of half-lives. The apparent volume of distribution in newborn was, as average, 350.6 ml/kg body weight. The average for children 5 years and older was smaller, 280.7 ml/kg. The peak level-dose ratio was 2.8 (micrograms X ml-1 X mg-1 X kg) in newborns. There was a tendency that this ratio increased with age. The average ratio for children over 5 years was 4.5 (micrograms X ml-1 X mg-1 X kg). In summary, the 2 remarkable observations obtained from the present study were; 1) The trend that the half-life of AMK shortens as the child grows older was clearest in neonatal period. 2) Peak serum level produced by the same dose per kilogram body weight had a tendency to increase with ages of children.