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Amikacin dosage in the preterm newborn.
The Journal of Antimicrobial Chemotherapy
|September 1, 1979
Summary
Amikacin dosing for preterm infants showed varied blood levels. A higher initial dose may be needed for severe infections, but no liver or kidney issues were observed.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Infectious Diseases
Background:
- Preterm infants often require antibiotics for suspected bacterial infections.
- Amikacin is a common aminoglycoside antibiotic used in neonatal care.
- Optimizing amikacin dosing is crucial to balance efficacy and minimize toxicity in neonates.
Purpose of the Study:
- To evaluate the pharmacokinetic profile of amikacin in preterm infants.
- To determine appropriate dosing strategies for amikacin in this population.
- To assess the safety of amikacin regarding hepatic and renal function.
Main Methods:
- Twenty-two preterm infants (26-34 weeks gestational age) received intramuscular amikacin (7.5 mg/kg every 12 hours).
- Blood amikacin levels were measured using radio-immunoassay.
- Peak (1-hour post-dose) and trough levels were analyzed.
Main Results:
- Significant variability in 1-hour peak amikacin levels (mean 18.2 mg/L) was observed.
- No significant drug accumulation was detected in trough levels.
- No adverse effects on hepatic or renal function were evident.
Conclusions:
- A loading dose of 10 mg/kg is recommended for amikacin in severe infections in preterm infants.
- Standard dosing requires careful monitoring due to pharmacokinetic variability.
- Amikacin appears safe concerning hepatic and renal function in this cohort.