Rozé J C, Tohier C, Rigal E, Drugeon B, Mouzard A
Service de Néonatologie, Hôpital Laënnec, Centre Hospitalier Universitaire de Nantes.
Arch Fr Pediatr. 1989 May;46(5):375-9.
Two consecutive studies of amikacin plasma levels were performed in 63 and 64 neonates whose postconceptional age (PCA) ranged from 26 to 45 weeks. The first study, using a dose of 7.5 mg/kg every 12 hours, permitted to establish a dosage related to PCA. Half-life elimination of amikacin was strongly correlated with PCA (r = -0.42, p = 0.0009). The apparent volume of distribution was correlated with none of the variables studied. The mean volume of distribution was 640 +/- 190 ml/kg. From these data, the inferred dosage was 10 mg/kg, given at intervals of time predetermined as a function of PCA. A second prospective study proved the value of this PCA adapted dosage. The maximal concentrations obtained were higher (21.6 +/- 5.9 vs 18.5 +/- 4.6 micrograms/ml, p less than 0.001), the nadir concentrations were not significantly increased (5.7 +/- 3.1 vs 5.2 +/- 3.7 micrograms/ml, NS) and the number of nadir concentrations outside the desired interval of 2-8 micrograms/ml was smaller (p less than 0.01).
对63例和64例孕龄（PCA）在26至45周之间的新生儿进行了两项连续的阿米卡星血药浓度研究。第一项研究中，每12小时给予7.5mg/kg的剂量，据此确定了与PCA相关的剂量。阿米卡星的消除半衰期与PCA密切相关（r = -0.42，p = 0.0009）。分布容积与所研究的任何变量均无相关性。平均分布容积为640 +/- 190ml/kg。根据这些数据，推断剂量为10mg/kg，给药间隔根据PCA预先确定。第二项前瞻性研究证实了这种根据PCA调整剂量的价值。获得的最大浓度更高（21.6 +/- 5.9对18.5 +/- 4.6μg/ml，p < 0.001），最低点浓度没有显著增加（5.7 +/- 3.1对5.2 +/- 3.7μg/ml，无显著性差异），且低于2-8μg/ml理想区间的最低点浓度数量更少（p < 0.01）。
