Rusconi F, Parini R, Cavanna G, Assael B M
Ther Drug Monit. 1983 Jun;5(2):179-83. doi: 10.1097/00007691-198306000-00005.
The purpose of this study was to analyze the role of gestational and postnatal age and of clinical conditions [e.g., respiratory distress syndrome (RDS)] on serum concentrations of amikacin in neonates treated according to commonly recommended dose schedules. Thirty-nine neonates (28.5-42 weeks of gestational age) were treated with the aminoglycoside at a mean dose of 7.2 mg/kg every 12 h for an average period of 6.5 days, and serum levels were monitored throughout treatment. Both gestational and postnatal age influenced amikacin levels. During the first days of life the presence of RDS was found to be strongly associated with amikacin accumulation. Neonates with retarded intrauterine growth according to their gestational age tended to have lower amikacin trough levels in the first days of life. No correlation was found between amikacin serum levels and hematocrit. Peak concentrations of the drug did not correlate with vital or clinical data, probably because of the variability in drug absorption from the intramuscular injection site. These data are discussed in light of the development of renal function and changes in body fluid compartments occurring in the preterm and term neonates during the first weeks of life.
本研究的目的是分析胎龄、出生后年龄以及临床状况[如呼吸窘迫综合征（RDS）]对按照常用推荐剂量方案治疗的新生儿血清阿米卡星浓度的影响。39例新生儿（胎龄28.5 - 42周）接受氨基糖苷类药物治疗，平均剂量为每12小时7.2 mg/kg，平均疗程为6.5天，治疗期间全程监测血清水平。胎龄和出生后年龄均影响阿米卡星水平。在出生后的头几天，发现RDS的存在与阿米卡星蓄积密切相关。根据胎龄，宫内生长迟缓的新生儿在出生后的头几天往往具有较低的阿米卡星谷浓度。未发现阿米卡星血清水平与血细胞比容之间存在相关性。药物的峰值浓度与生命体征或临床数据无关，这可能是由于肌肉注射部位药物吸收的变异性所致。根据出生后最初几周内早产儿和足月儿肾功能的发育以及体液 compartments 的变化对这些数据进行了讨论。
