Andronikou S, Giapros V I, Cholevas V I, Papadopoulou Z L
Department of Pediatrics and Pediatric Nephrology, University of Ioannina Medical School, Greece.
Pediatr Nephrol. 1996 Dec;10(6):766-8. doi: 10.1007/s004670050214.
The effect of aminoglycosides on renal function was evaluated in 30 full-term infants who were treated within 24 h of birth with either amikacin (10 infants, group A), gentamicin (9 infants, group B), or netilmicin (10 infants, group C). Renal function was assessed before, during, and 48 h after discontinuation of therapy by measuring the plasma creatinine concentration (PCr), the fractional excretion of sodium (FENa), potassium, magnesium, phosphate (FEP), uric acid, and the urinary excretion of calcium (UCA/UCr ratio) immediately before (trough) and after (peak) the infusion of the aminoglycosides. The results were compared with 10 control newborns who did not receive antibiotics. Significant alterations in renal function were observed only during therapy with gentamicin (group B). These consisted of a sustained elevation of FENa and UCa/UCr ratio throughout therapy, a latent increase in FEP on the 7th day (P < 0.05), and lack of the normal postnatal decline of PCr in 3 of 9 infants (P < 0.01). These abnormalities persisted up to 2 days after discontinuation of therapy. Therapeutic doses of gentamicin may result in significant electrolyte disturbances in sick full-term infants.
在30例足月婴儿中评估了氨基糖苷类药物对肾功能的影响，这些婴儿在出生后24小时内接受了阿米卡星治疗（10例婴儿，A组）、庆大霉素治疗（9例婴儿，B组）或奈替米星治疗（10例婴儿，C组）。在治疗前、治疗期间以及停药后48小时，通过测量血浆肌酐浓度（PCr）、钠分数排泄率（FENa）、钾、镁、磷分数排泄率（FEP）、尿酸以及在输注氨基糖苷类药物之前（谷值）和之后（峰值）立即测量的尿钙排泄量（UCA/UCr比值）来评估肾功能。将结果与10例未接受抗生素治疗的对照新生儿进行比较。仅在庆大霉素治疗期间（B组）观察到肾功能有显著改变。这些改变包括整个治疗期间FENa和UCa/UCr比值持续升高，第7天FEP潜在升高（P<0.05），以及9例婴儿中有3例PCr未出现正常的出生后下降（P<0.01）。这些异常在停药后持续长达2天。治疗剂量的庆大霉素可能会导致患病足月婴儿出现显著的电解质紊乱。
