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Clinical pharmacokinetics of amikacin in hypoxic premature foals

S L Green1, P D Conlon

  • 1Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Ontario, Canada.

Equine Veterinary Journal
|July 1, 1993
PubMed

Insights

Premature, hypoxic foals exhibit prolonged amikacin serum half-life, necessitating adjusted dosage schedules. Careful monitoring and individualized dosing are crucial for maintaining therapeutic amikacin concentrations and preventing toxicity.

Area of Science:

  • Veterinary Pharmacology
  • Neonatal Medicine
  • Critical Care Medicine

Background:

  • Amikacin is a critical antibiotic for treating severe bacterial infections in foals.
  • Understanding amikacin pharmacokinetics in vulnerable neonatal populations is essential for effective treatment.
  • Prematurity and hypoxia can significantly alter drug metabolism and elimination in foals.

Purpose of the Study:

  • To evaluate amikacin pharmacokinetics in critically ill, hypoxic premature foals.
  • To compare amikacin pharmacokinetics between premature and full-term neonatal foals.
  • To determine optimal amikacin dosage regimens for achieving therapeutic plasma concentrations in premature foals.

Main Methods:

  • Pharmacokinetic analysis of amikacin administered intravenously (IV) at 7 mg/kg every 8 hours.
  • Comparison of amikacin serum half-life and elimination rate constants between premature and full-term foals.
  • Calculation of adjusted dosage schedules to maintain target peak (>15 µg/ml, <30 µg/ml) and trough (<3 µg/ml) amikacin concentrations.

Main Results:

  • Premature foals showed a significantly prolonged amikacin serum half-life (5.39 ± 3.46 h) and a slower elimination rate (0.17 ± 0.09 h-1).
  • Dosage adjustments included increasing the dose (8.5-10.5 mg/kg) and extending the interval (12-24 h) in premature foals.
  • Overall amikacin dosage was reduced in premature foals to achieve target therapeutic ranges.

Conclusions:

  • Prematurity and hypoxia are key factors contributing to altered amikacin pharmacokinetics, specifically a prolonged half-life, in foals.
  • Individualized amikacin dosage adjustments are vital for hypoxic, premature foals to ensure efficacy and safety.
  • While no amikacin-induced nephrotoxicity was observed, continuous monitoring and tailored dosing are strongly recommended.

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