Gentamicin pharmacokinetics in neonates with patent ductus arteriosus
| Autor: | McCrae Smith, Ransom Jl, Peter Gal, Williams Bs, Schall Sa, Rita Q. Carlos |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities Gestational Age Critical Care and Intensive Care Medicine Cohort Studies Pharmacokinetics Predictive Value of Tests Intensive Care Units Neonatal Intensive care Ductus arteriosus Humans Medicine cardiovascular diseases Infusions Intravenous Ductus Arteriosus Patent Antibacterial agent business.industry Aminoglycoside Infant Newborn Anti-Bacterial Agents medicine.anatomical_structure Recien nacido Anesthesia embryonic structures cardiovascular system Gentamicin Gentamicins business Cohort study medicine.drug |
| Zdroj: | Critical Care Medicine. 25:273-275 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/00003246-199702000-00013 |
| Popis: | To determine the effect of patent ductus arteriosus on the pharmacokinetics of gentamicin in neonates and to examine whether any particular pharmacokinetic parameter is of value as a marker of patent ductus arteriosus.Cohort study of neonates treated with gentamicin, according to a standard dosing protocol.A 24-bed, Level III, neonatal intensive care unit.Neonates treated with gentamicin at the time of admission to the neonatal intensive care unit, using a standard protocol, and who were36 wks of gestational age.All patients received a gentamicin loading dose, and had gentamicin concentrations measured at 2 and 12 hrs after this dose, in order to determine pharmacokinetic parameters and calculate the optimum maintenance dose. Those neonates subsequently diagnosed to have patent ductus arteriosus, based on clinical suspicion and echocardiographic confirmation, were compared with those neonates without clinically suspected patent ductus arteriosus. Gentamicin pharmacokinetic parameters were calculated using a one-compartment model.A total of 322 courses of gentamicin were administered (patent ductus arteriosus, n = 106; control, n = 216). Gentamicin clearance was decreased in the patent ductus arteriosus group vs. the control group (40.02 vs. 44.73 mL/kg/hr; p.0108). Volume of distribution was greater for patent ductus arteriosus patients (0.61 L/kg) than for controls (0.54 L/kg) (p.0002). Also, volume of distribution was a useful marker for presence of patent ductus arteriosus, with a 92% specificity for patent ductus arteriosus.Gentamicin dosing should be altered in neonates with patent ductus arteriosus to reflect the impact of higher volume of distribution and lower clearance. When the gentamicin volume of distribution exceeds 0.7 L/kg, it may be of predictive value for the presence of patent ductus arteriosus. |
| Databáze: | OpenAIRE |
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