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KMID : 0869620000170010147
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Journal of Korean Society of Hospital Pharmacists
2000 Volume.17 No. 1 p.147 ~ p.152
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Amikacin Pharmacokinetics and Proposed Dosing Guideline Added Once-Daily Therapy for the Korean Neonates
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박윤희/Park, Yun Hee
김승란/김정태/이용선/조영환/노환성/피수영/Kim, Seung Ran/Kim, Jeong Tae/Lee, Young Sun/Cho, Young Hwan/Ro, Hwan Seong/Pi, Sue Young
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Abstract
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As maturational change influence the clearance of amikacin in the developing neonate, the dosage and interval of amikacin must be selected cautiously. Neofax 99^(®) revised edition accepted fundamental concept of the once-daily therapy, but there is no suggested on the initial dosing guideline after the first week of life, and only a limited studied of amikacin for the Korean neonate are available. The aim of this study is to clear the pharmacokinetics of amikacin in Korean neonate and to establish a new dosing guideline added once-daily therapy with these pharmacokinetics. In the present study, the pharmacokinetics of amikacin have been studied in 42 Korean neonate having normal kidney function. Correlation between pharmacokinetic parameters and patient characteristics was evaluated with the linear regression analysis. A statistically significant association were found between PCA and clearance (r=0.446), half-life (r=0.288) and elimination constant (r=0.518), but there was no significant relationship between PCA and volume of distribution. Based on these results, we classified the neonate of PNA>7 days into four group by PCA, and propose a new dosage schedule added once-daily therapy : fixed dosage 12㎎/㎏, group 1; PCA≤29 weeks/24 hour, group 2 ; PCA 30 to 36 and PNA 7 to 14 days/24 hour, group 3 ; PCA 30 to 36 and PNA>14 days/18 hour, group 4 ; PCA≥37 / 12 hour. Our proposed dosage schedule may be useful in establishing the initial dosing interval, and more therapeutic effect with a further increase in the dosage and a lengthening of the dosage regimen.
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