Brion L P, Fleischman A R, Schwartz G J
Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York 10461.
Pediatr Nephrol. 1991 Nov;5(6):675-9. doi: 10.1007/BF00857868.
We evaluated the relationship between gentamicin pharmacokinetics and glomerular filtration rate in newborn infants to estimate the appropriate interval of administration in neonates with renal insufficiency. Gentamicin half-life (Gt1/2) could be predicted from plasma creatinine concentration (PCr) (r = 0.78); the prediction was minimally but significantly increased (r = 0.81) by adding post-conceptional age to a multiple regression analysis. Infants with a postconceptional age of 29 weeks or more and a PCr of 1 mg/dl or more had significantly greater through and peak gentamicin levels than those with a PCr less than 1 mg/dl. If gentamicin is indicated in a patient with renal insufficiency, the interval of administration should be 2-3 Gt1/2, which can be estimated from PCr (Gt1/2 = 2.0 + 7.7 PCr). The interval can then be adjusted according to peak and trough gentamicin levels.
我们评估了新生儿庆大霉素药代动力学与肾小球滤过率之间的关系,以估计肾功能不全新生儿的合适给药间隔。庆大霉素半衰期(Gt1/2)可根据血浆肌酐浓度(PCr)预测(r = 0.78);在多元回归分析中加入孕龄后,预测值虽有小幅但显著提高(r = 0.81)。孕龄29周或以上且PCr为1mg/dl或更高的婴儿,其庆大霉素的谷浓度和峰浓度显著高于PCr低于1mg/dl的婴儿。如果肾功能不全患者需要使用庆大霉素,给药间隔应为2 - 3个Gt1/2,可根据PCr估算(Gt1/2 = 2.0 + 7.7PCr)。然后可根据庆大霉素的峰浓度和谷浓度调整给药间隔。