Summary
The recommended neonatal dosage regime for amikacin of 15 mg/kg/day was found to be unsatisfactory in four neonates and a loading dose of 10 mg/kg did not improve levels in two further newborns with normal renal function. Fourteen neonates on 20 mg/kg/day regime achieved satisfactory levels; peak values were 21.5±4.5 µg/ml and trough levels 3.34±2.05 µg/ml. Peak time ranged from 17 to 60 minutes and varied with the dose given. The half-life was related to plasma creatinine, urea, post-natal age and weight. Thirteen neonates with pre-existing renal impairment were managed by alteration of dosage interval or quantity given. Side-effects were confined to eosinophilia in six infants, and no definite nephrotoxicity or gross eighth nerve damage was demonstrated.
Zusammenfassung
Es zeigte sich, daß das für Neugeborene empfohlene Dosierungsschema für Amikacin von 15 mg/kg/Tag bei vier Neugeborenen nicht zufriedenstellend war und eine Anfangsdosis von 10 mg/kg bei zwei weiteren Neugeborenen mit normaler Nierenfunktion nicht zu einer Verbesserung der Spiegel führte. Vierzehn Neugeborene erreichten mit 20 mg/kg/Tag zufriedenstellende Spiegel; die Spitzenwerte betrugen 21,5±4,5 µg/ml und die mittleren Spiegel lagen bei 3,34±2,05 µg/ml. Die Maxima wurden zwischen 17 und 60 Minuten erreicht und wechselten mit der verabreichten Dosis. Die Halbwertszeit stand in Relation zu Plasmacreatinin, Harnstoff, Lebensalter und Gewicht. Dreizehn Neugeborene mit vorbestehender Nierenstörung konnten wir durch Änderung des Dosierungsintervalls oder der verabreichten Dosis behandeln. Nebenwirkungen beschränkten sich auf Eosinophilie bei sechs Kindern. Zeichen für eine ausgesprochene Nephrotoxizität oder erhebliche Störungen des achten Hirnnerven konnten nicht festgestellt werden.
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Cookson, B., Williams, J.D., Tripp, J. et al. Evaluation of amikacin dosage regimes in the low and very low birthweight newborn. Infection 8 (Suppl 3), S239–S242 (1980). https://doi.org/10.1007/BF01639588
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DOI: https://doi.org/10.1007/BF01639588