Cleary T G, Pickering L K, Kramer W G, Culbert S, Frankel L S, Kohl S
Antimicrob Agents Chemother. 1979 Dec;16(6):829-32. doi: 10.1128/AAC.16.6.829.
The pharmacokinetics of amikacin were evaluated in 50 pediatric patients (1 to 17 years of age) with malignancies and normal renal function. Dosage regimens of 5 mg/kg per dose were administered intravenously (i) over 30 min every 8 h, (ii) over 60 min every 8 h, and (iii) over 60 min every 6 h. Administration of amikacin over 30 min produced concentrations in serum of 29.3 +/- 5.7 micrograms/ml at the end of the infusion and subtherapeutic concentrations 4 h after the infusion. The regimen of 20 mg/kg per 24 h, divided into doses given every 6 h infused over 60 min, achieved concentrations in serum at the end of the infusion of 17.2 +/- 1.7 micrograms/ml and at 6 h of 1.2 +/- 0.3 microgram/ml. The serum half-life was 1.24 +/- 0.09 h, volume of distribution was 0.26 +/- 0.02 liter/kg, and total body clearance rate was 131 +/- 10 ml/min per 1.73 m2. No accumulation of amikacin was noted, and no significant side effects could be attributed to the drug. This study suggests that the optimal initial dosage regimen of amikacin in children is 20 mg/kg per 24 h administered in equal doses every 6 h over 60 min; however, optimal therapy requires individualization of dosage based on measured serum concentrations and susceptibility data on bacterial pathogens isolated.
对50例患有恶性肿瘤且肾功能正常的儿科患者（1至17岁）进行了阿米卡星的药代动力学评估。剂量方案为：（i）每8小时静脉注射5mg/kg，持续30分钟；（ii）每8小时静脉注射5mg/kg，持续60分钟；（iii）每6小时静脉注射5mg/kg，持续60分钟。30分钟静脉注射阿米卡星后，输注结束时血清浓度为29.3±5.7μg/ml，输注后4小时浓度低于治疗浓度。每24小时20mg/kg的剂量方案，分为每6小时一次，每次持续60分钟静脉输注，输注结束时血清浓度为17.2±1.7μg/ml，6小时时为1.2±0.3μg/ml。血清半衰期为1.24±0.09小时，分布容积为0.26±0.02升/千克，总体清除率为每1.73平方米131±10毫升/分钟。未观察到阿米卡星的蓄积，且未发现该药物有明显副作用。本研究表明，儿童阿米卡星的最佳初始剂量方案为每24小时20mg/kg，每6小时等剂量静脉输注60分钟；然而，最佳治疗需要根据测得的血清浓度和分离出的细菌病原体的药敏数据进行个体化给药。
