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[Investigation on the use of amikacin in the newborn]
Abstract:
The use of amikacin (AMK) in newborns was investigated and the results obtained are summarized as follows. 1. AMK was administered to 3 rabbits at an intramuscular dose of 6 mg/kg. Mean blood levels determined according to methods of bioassay (BIO) and fluorescent immunoassay (FIA) were 28.6 and 22.2 micrograms/ml, respectively, at 30 minutes after dosing. Then, the blood levels declined rapidly. Mean T 1/2 values obtained with the above 2 assay methods were 0.76 and 0.63 hours, respectively. 2. When AMK was administered at a dose of 5.7 mg/kg to a 64 day-old newborn by drip intravenous infusion for 30 minutes, a peak blood level was attained at the end of drip intravenous infusion, which was 20.0 micrograms/ml according to BIO and was 15.5 micrograms/ml according to FIA. The blood levels declined gradually thereafter with a T 1/2 value of 2.33 hours (BIO) or 2.03 hours (FIA). When the drug was administered at 5.3 mg/kg to a 26 day-old newborn using the same infusion method, the peak blood level obtained at the end of drip intravenous infusion was 18.0 micrograms/ml according to BIO and was 14.8 micrograms/ml according to FIA, and T 1/2 values were 4.76 and 3.68 hours, respectively. 3. As there was a close correlation between the values obtained with BIO and with FIA in both rabbits and clinical cases, with a coefficient of 0.990, and also the BIO values could be estimated using a formula of FIA value X 1.2 + 2.2, it would be possible to monitor AMK levels in the blood of patients at bedside using the FIA.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
This study investigated amikacin (AMK) levels in newborns. Fluorescent immunoassay (FIA) provides a reliable and potentially bedside method for monitoring AMK blood concentrations, correlating closely with bioassay (BIO) methods.
Area of Science:
- Pharmacokinetics
- Clinical Chemistry
- Neonatal Medicine
Context:
- Amikacin (AMK) is a crucial antibiotic for treating neonatal infections.
- Accurate therapeutic drug monitoring is essential for optimizing efficacy and minimizing toxicity in neonates.
- Existing bioassay (BIO) methods for AMK quantification can be time-consuming.
Purpose:
- To evaluate the pharmacokinetics of amikacin in newborn rabbits and human neonates.
- To compare the accuracy and correlation of fluorescent immunoassay (FIA) with traditional bioassay (BIO) for AMK blood level determination.
- To assess the feasibility of using FIA for bedside monitoring of AMK in neonates.
Summary:
- Intramuscular administration of AMK in rabbits showed rapid decline in blood levels with short half-lives (T 1/2) of approximately 0.7 hours.
- Intravenous drip infusion of AMK in neonates resulted in peak blood levels and elimination half-lives that varied with age, ranging from 2.0 to 4.7 hours.
- A strong correlation (coefficient of 0.990) was observed between BIO and FIA methods, with FIA values accurately estimating BIO values.
Impact:
- Fluorescent immunoassay (FIA) offers a viable alternative to bioassay (BIO) for therapeutic drug monitoring of amikacin.
- The high correlation suggests FIA can be utilized for convenient and potentially rapid bedside monitoring of AMK levels in neonates.
- This facilitates optimized dosing strategies to improve treatment outcomes and reduce the risk of nephrotoxicity and ototoxicity associated with amikacin therapy.
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