Pilars de Pilar C E
Klin Padiatr. 1976 Sep;188(5):418-23.
On the basis of our experience with 50 prematures and newborns and 200 serum level analyses, Gentamycin doses of larger than or equal to 5 mg/kg body weight/day (depending on the pathogenic sensitivity) is necessary in life-threatening infections to obtain a serum level of 4-5 mug/ml. Our findings in this regard correspond with the results of other authors with comparable test systems. However, we found that in ill prematures and newborns, an accumulation inside of 7-10 days is the rule rather than the exception. With increasing length of therapy, Gentamycin treatment should be discontinued if the general condition and/or kidney function worsens. Treatment should be discontinued until the serum concentration has been established or a drop in serum creatine occurs. If there is no possibility of conducting control checks, Gentamycin therapy should not extend more than one week and should not exceed 2 mg/kg body weight/day for prematures and newborns. The available tests for determinin aminoglycosides in the serum must be simplified and standardized so that they can be more readily used. Such a simplification and standardization is possible as we have shown. In this way a basis is established for future follow-up checks and the risk of side effects in the inner ear and kidneys is reduced. The same is true for the new aminoglycosides Tobramycin, Amicacin, Sisomycin.
基于我们对50例早产儿和新生儿以及200次血清水平分析的经验，对于危及生命的感染，为使血清水平达到4 - 5微克/毫升，庆大霉素剂量需大于或等于5毫克/千克体重/天（取决于病原菌敏感性）。我们在这方面的研究结果与其他采用类似测试系统的作者的结果相符。然而，我们发现，患病的早产儿和新生儿在7 - 10天内出现药物蓄积是常例而非例外。随着治疗时间延长，如果一般状况和/或肾功能恶化，应停止庆大霉素治疗。治疗应暂停，直至确定血清浓度或血清肌酐下降。如果无法进行对照检查，庆大霉素治疗不应超过一周，对于早产儿和新生儿，剂量不应超过2毫克/千克体重/天。用于测定血清中氨基糖苷类药物的现有检测方法必须简化和标准化，以便更易于使用。正如我们所表明的，这种简化和标准化是可行的。这样就为未来的随访检查奠定了基础，并降低了内耳和肾脏出现副作用的风险。新的氨基糖苷类药物妥布霉素、阿米卡星、西索米星也是如此。
