Lulic-Botica Mirjana, Sheer Terri, Edwards David, Thomas Ronald L, Natarajan Girija
Department of Pharmacy, Hutzel Women's Hospital, Detroit, MI, USA; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.
J Clin Pharmacol. 2014 Jan;54(1):39-45. doi: 10.1002/jcph.190. Epub 2013 Oct 31.
We compared gentamicin pharmacokinetics among neonates born small-for-gestational age (SGA) and appropriate for gestational age (AGA). We further compared gentamicin pharmacokinetics in subgroups of AGA and SGA neonates born preterm and term and treated within and after the initial week of age. Steady state peak and trough serum gentamicin concentrations were used to calculate clearance (Cl), elimination constant (Kel), volume of distribution (Vd), and half-life (t1/2 ) in infants (n = 236) who received ≥48 hours therapy. Statistical analyses (SPSS 17.0) included chi-square and the non-parametric Mann-Whitney U-test. SGA infants treated early (≤7days) (n = 29) and at postmenstrual ages ≤32 weeks (n = 23) had significantly lower median Kel (0.069/h vs. 0.081/h and 0.067/h vs. 0.075/h) and clearance (0.58 mL/kg/min vs. 0.68 mL/kg/min and 0.46 mL/kg/min vs. 0.65 mL/kg/min), compared to those born AGA. There were no significant differences in pharmacokinetic profiles with later therapy or at more mature ages. The prolonged half-life of gentamicin may need to be considered in dosing regimens for preterm SGA infants in the initial week of life.
我们比较了小于胎龄儿（SGA）和适于胎龄儿（AGA）出生的新生儿的庆大霉素药代动力学。我们进一步比较了早产和足月出生且在出生后第一周内及之后接受治疗的AGA和SGA新生儿亚组的庆大霉素药代动力学。在接受≥48小时治疗的婴儿（n = 236）中，使用稳态峰和谷血清庆大霉素浓度来计算清除率（Cl）、消除常数（Kel）、分布容积（Vd）和半衰期（t1/2）。统计分析（SPSS 17.0）包括卡方检验和非参数曼-惠特尼U检验。与AGA出生的婴儿相比，早期（≤7天）治疗的SGA婴儿（n = 29）和月经后年龄≤32周的婴儿（n = 23）的中位Kel（0.069/h对0.081/h和0.067/h对0.075/h）和清除率（0.58 mL/kg/min对0.68 mL/kg/min和0.46 mL/kg/min对0.65 mL/kg/min）显著更低。后期治疗或年龄更大时，药代动力学特征无显著差异。在出生后第一周的早产SGA婴儿给药方案中，可能需要考虑庆大霉素半衰期延长的情况。
