Related Experiment Videos
[Pharmacokinetics of amikacin in children and neonates]
T Motohiro1, K Tanaka, A Kawakami
1Department of Pediatrics, School of Medicine, Kurume University.
Insights
This study evaluated amikacin pharmacokinetics in pediatric patients, finding dose-dependent plasma levels and higher urinary recovery in children compared to adults. Neonates showed longer half-lives and lower urinary recovery due to immature renal function.
Area of Science:
- Pharmacology
- Pediatric Medicine
- Antibiotic Therapy
Context:
- Aminoglycoside antibiotics like amikacin are crucial for treating bacterial infections in children.
- Understanding amikacin pharmacokinetics in pediatric populations is essential for optimizing dosing and ensuring efficacy.
- Limited data exists on amikacin pharmacokinetics across different pediatric age groups and administration routes.
Purpose:
- To investigate the pharmacokinetic profile of amikacin in pediatric patients.
- To determine plasma and urinary amikacin levels following intravenous and intramuscular administration.
- To compare pharmacokinetic parameters between children, neonates, and adults.
Summary:
- Intravenous amikacin in children aged 2 days to 11 years demonstrated dose-dependent plasma peaks, with similar half-lives and AUCs to adults but lower Vd.
- Intramuscular administration in neonates showed dose-dependent peaks, longer half-lives in younger infants, and significantly lower urinary recovery rates compared to adults and children, attributed to immature renal function.
- Urinary recovery rates in children were comparable to or higher than adults, while neonates exhibited markedly lower rates.
Impact:
- Provides crucial pharmacokinetic data for amikacin in pediatric patients, aiding in the development of evidence-based dosing guidelines.
- Highlights the differences in amikacin disposition between children and neonates, emphasizing the need for age-specific considerations.
- Informs clinical practice regarding amikacin use in neonates, suggesting potential adjustments due to immature renal function and altered drug metabolism.
Abstract:
To evaluate pharmacokinetics of amikacin (AMK), one of the aminoglycoside antibiotics, children with ages from 2 days to 11 years were treated with various doses by various administration routes, and both plasma and urinary levels of AMK were determined. The following is a summary of the results obtained: 1. Of 6 children, three were treated with 2.0 mg/kg of AMK by a 30-minute intravenous drip infusion, and the other 3 with 4.0 mg/kg by a 60-minute. Peaks of average plasma levels were observed at the ends of the infusions in both cases, and their levels were 9.23 and 13.67 micrograms/ml, respectively, showing a dose-dependency. Both half-lives and areas under plasma concentration-time curves (AUCs) were similar to those of adults. However, the volume of distribution (Vd) showed a lower value than that of adults. Peaks of average urine levels were 149.3 micrograms/ml with 2.0 mg/kg in 0-2 hours after the start of the infusion and 223.3 micrograms/ml with 4.0 mg/kg in 2-4 hours. Average urinary recovery rates within 6 hours after the start of the infusion were 95.4% with 2.0 mg/kg and 85.7% with 4.0 mg/kg. These recoveries were equal to or higher than that of adults. 2. When 3.0, 4.0 and 6.0 mg/kg of AMK were administered to 3 groups of mature or premature babies by intramuscular injection, average peak levels of AMK in plasma were 6.26, 8.61 and 12.60 micrograms/ml, respectively, at 30 minutes after the injection, showing dose-dependency. In these groups, the younger the day age after birth was, the longer the half-life became. The AUCs were larger as the half-life became longer. The Vd was larger than that in the intravenous drip infusion group, but, any particular was not observed. Average peak levels of AMK in urine were 78.83 micrograms/ml at 4-6 hours with a dose level of 3.0 mg/kg, 99.17 micrograms/ml at 2-4 hours with 4.0 mg/kg and 139.20 micrograms/ml at 0-2 hours with 6.0 mg/kg. Average urinary recovery rates within 6 hours were 36.57% with 3.0 mg/kg, 34.67% with 4.0 mg/kg and 43.77% with 6.0 mg/kg. These recovery rates were markedly lower than those observed in adults and children. One of the causes of this low recovery is that mature and premature babies have immature renal functions. 3. When 3.0 mg/kg of AMK was administered to three premature babies by a 30-minute intravenous drip infusion, the average peak plasma levels was 7.61 micrograms/ml at the end of the drip infusion.(ABSTRACT TRUNCATED AT 400 WORDS)