Kanthawatana S, Uruwannakul K, Chotinarumon S
Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Thailand.
J Med Assoc Thai. 1998 Feb;81(2):136-40.
A pharmacokinetic study of gentamicin was performed on 32 Thai neonates. After a single intravenous infusion of gentamicin at 2.5 mg/kg body weight, blood samples were collected at 0.5 and 12 hours. Serum gentamicin concentrations were determined with use of fluorescence polarizing immunoassay. None of the neonates with < 28 weeks post conceptional age (PCA), contrary to most of the more mature neonates, achieved the recommended therapeutic peak concentrations. The volume of distribution (Vd) and elimination half-life (T1/2) of gentamicin were found to reversely correlate with the PCA, with significantly larger Vd and longer T1/2 values observed among the premature neonates. Our findings were similar the results previously reported in Caucasians, and thus strongly indicated the necessity of gentamicin dosage adjustment among Thai neonates according to their PCA. A gentamicin dosing guideline for Thai neonates has been proposed, nonetheless, with higher doses and longer dosing intervals recommended among premature neonates.
对32名泰国新生儿进行了庆大霉素的药代动力学研究。在以2.5毫克/千克体重单次静脉输注庆大霉素后，于0.5小时和12小时采集血样。使用荧光偏振免疫测定法测定血清庆大霉素浓度。与大多数成熟度较高的新生儿相反，胎龄小于28周的新生儿均未达到推荐的治疗峰值浓度。发现庆大霉素的分布容积（Vd）和消除半衰期（T1/2）与胎龄呈负相关，在早产儿中观察到Vd明显更大且T1/2值更长。我们的研究结果与先前在白种人中报道的结果相似，因此强烈表明泰国新生儿需要根据其胎龄调整庆大霉素剂量。尽管如此，已提出了泰国新生儿庆大霉素给药指南，建议在早产儿中使用更高剂量和更长给药间隔。
