Ettlinger J J, Bedford K A, Lovering A M, Reeves D S, Speidel B D, MacGowan A P
Department of Neonatal Medicine, Southmead Health Services NHS Trust, Southmead Hospital, Westbury-on-Trym, Bristol, UK.
J Antimicrob Chemother. 1996 Sep;38(3):499-505. doi: 10.1093/jac/38.3.499.
The pharmacokinetics of once a day netilmicin (6 mg/kg) was studied in 21 neonates. The babies were divided into three groups according to gestational age: group I aged > 36 weeks; group II between 34-36 weeks and group III < 34 weeks. Serum concentrations were variable between patients and the concentration 24 h after the first dose ranged from 0.8 to 3.8 mg/L with only two babies having concentrations of < 1 mg/L while seven had concentrations of > 2 mg/L. There were also large patient-to-patient variations in serum half-life, volume of distribution, area under the curve and relative plasma clearance such that these parameters could not be correlated to gestational age or weight. Absolute plasma clearance was correlated with both gestational age and weight. There was evidence of accumulation between the first and second dose for all three patient groups and for patients of gestational age < 34 weeks (group III) these observations were statistically significant. A netilmicin dosage of 4.5 mg/kg once a day may be more suitable for all neonates supported by assay of serum concentrations.
对21例新生儿进行了一日一次奈替米星（6mg/kg）的药代动力学研究。根据胎龄将婴儿分为三组：第一组胎龄>36周；第二组胎龄在34 - 36周之间；第三组胎龄<34周。患者之间血清浓度存在差异，首剂给药后24小时的浓度范围为0.8至3.8mg/L，只有两名婴儿的浓度<1mg/L，而七名婴儿的浓度>2mg/L。血清半衰期、分布容积、曲线下面积和相对血浆清除率在患者之间也存在很大差异，因此这些参数与胎龄或体重无关。绝对血浆清除率与胎龄和体重均相关。所有三个患者组在首剂和第二剂之间均有蓄积迹象，对于胎龄<34周的患者（第三组），这些观察结果具有统计学意义。根据血清浓度测定结果，一日一次4.5mg/kg的奈替米星剂量可能更适合所有新生儿。
