Trujillo H, Manotas R, Londono R, Ramirez J I, Uribe A, De Vidal E L, Agudelo N
J Infect Dis. 1976 Nov;134 SUPPL:S406-11. doi: 10.1093/infdis/135.supplement_2.s406.
Thirty (86%) of 35 infants and older children with proven gram-negative sepsis had a complete clinical remission after treatment with amikacin. In 27 (82%) of 33 infectious episodes for which bacteriologic results were available before and after treatment, the organism was eradicated. The dosage of amikacin was either 7.5 mg/kg or 15 mg/kg given intramuscularly at 12-hr intervals. No adverse clinical effects or laboratory abnormalities were observed during treatment, which lasted from five to 14 days. All bacteria were sensitive to amikacin when tested by the disk diffusion method, and all but a single strain of Pseudomonas were sensitive when tested by the agar dilution method. Assays of serum and urine demonstrated adequate levels of amikacin after single intramuscular injections of 3.75 or 7.5 mg/kg; simultaneous assays of serum and cerebrospinal fluid in two cases demonstrated comparable concentrations of drug suggestive of a high degree of penetration into the cerebrospinal fluid in two cases demonstrated comparable concentrations of drug suggestive of a high degree of penetration into the cerebrospinal fluid during infection. Serial measurements of amikacin in serum from 0.5 to 12 hr after administration of single doses of 7.5 mg of drug/kg to six newborns revealed no significant differences in the concentrations achieved with intramuscular or intravenous administration of the drug.
35例确诊为革兰氏阴性菌败血症的婴幼儿及大龄儿童中，30例（86%）在接受阿米卡星治疗后临床完全缓解。在33次有治疗前后细菌学结果的感染发作中，27例（82%）的病原体被清除。阿米卡星剂量为7.5mg/kg或15mg/kg，每12小时肌肉注射一次。治疗持续5至14天，期间未观察到不良临床效应或实验室异常。采用纸片扩散法检测时，所有细菌对阿米卡星敏感；采用琼脂稀释法检测时，除一株铜绿假单胞菌外，所有菌株均敏感。单次肌肉注射3.75或7.5mg/kg后，血清和尿液检测显示阿米卡星水平充足；两例同时检测血清和脑脊液，结果显示药物浓度相当，提示感染期间药物可高度渗透进入脑脊液。对6例新生儿单次给予7.5mg药物/kg后，在0.5至12小时内对血清中阿米卡星进行连续测量，结果显示肌肉注射或静脉注射该药物后所达到的浓度无显著差异。
