Wagner B P, Pfenninger J
Intensive Care Unit, University Children's Hospital, Inselspital, Bern, Switzerland.
Intensive Care Med. 1994 May;20(5):365-7. doi: 10.1007/BF01720910.
To examine a once daily dosing regimen of netilmicin in critically ill neonates and children.
Open, prospective study on 81 antibiotic courses in 77 critically ill neonates and children, hospitalized in a multidisciplinary pediatric/neonatal intensive care unit. For combined empiric therapy (aminoglycoside and beta-lactam), netilmicin was given intravenously over 5 min once every 24 h. The dose ranged from 3.5-6 mg/kg, mainly depending upon gestational and postnatal age. Peak levels were determined by immunoassay 30 min after the second dose and trough levels 1 h before the third and fifth dose or after adaptation of dosing.
All peak levels (n = 28) were clearly above 12 mumol/l (mean 22, range 13-41 mumol/l). Eighty-nine trough levels were within desired limits (< 4 mumol/l) and 11 (11%) above 4 mumol/l, mostly in conjunction with impaired renal function.
Optimal peak and trough levels of netilmicin can be achieved by once daily dosing, adapted to gestational/postnatal age and renal function.
研究奈替米星在危重新生儿和儿童中的每日一次给药方案。
对77例危重新生儿和儿童进行的81个抗生素疗程的开放性前瞻性研究，这些患儿均住院于多学科儿科/新生儿重症监护病房。对于联合经验性治疗（氨基糖苷类和β-内酰胺类），奈替米星每24小时静脉滴注一次，持续5分钟。剂量范围为3.5 - 6毫克/千克，主要取决于胎龄和出生后年龄。在第二次给药后30分钟通过免疫测定法测定峰浓度，在第三次和第五次给药前1小时或调整剂量后测定谷浓度。
所有峰浓度（n = 28）均明显高于12微摩尔/升（平均22，范围13 - 41微摩尔/升）。89个谷浓度在理想范围内（< 4微摩尔/升），11个（11%）高于4微摩尔/升，大多与肾功能受损有关。
根据胎龄/出生后年龄和肾功能调整剂量，每日一次给药可使奈替米星达到最佳峰浓度和谷浓度。
