The need for a loading dose of gentamicin in neonates.
The need for a loading dose of gentamicin in neonates.
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新生儿需要庆大霉素的负荷剂量。
DOI：
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发表时间：
1989
期刊：
影响因子：
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通讯作者：
C. Backstrom
中科院分区：
文献类型：
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作者：
K. Watterberg;Kelly Hw;P. Angelus;C. Backstrom
我们研究了100名新生儿的药代动力学变量，以评估庆大霉素负荷剂量的必要性。该人群中庆大霉素的平均分布容积为0.542 +/-0.205 L/kg。这些患者中有45%在一次2.5 mg/kg剂量后不会达到大于或等于5 μ g/ml的血清峰浓度。4 mg/kg的负荷剂量将导致92%的患者的水平大于或等于5微克/毫升。本研究后，在我们机构开始4 mg/kg负荷剂量。在接受负荷剂量的50例患者和未接受负荷剂量的40例患者中比较了稳态时的峰浓度和谷浓度。在三次或更多次给药后，未发现峰浓度或谷浓度存在显著差异，验证了负荷剂量不影响稳态浓度。由于庆大霉素毒性与随着时间的累积有关，而治疗效果可能与早期达到治疗峰值血清浓度有关，因此我们建议所有开始庆大霉素治疗的新生儿的负荷剂量为4 mg/kg。
We studied pharmacokinetic variables in 100 neonates to evaluate the need for a loading dose of gentamicin. The mean volume of distribution for gentamicin in this population was .542 +/- .205 L/kg. Forty-five percent of these patients would not achieve peak serum concentrations of greater than or equal to 5 micrograms/ml after one dose of 2.5 mg/kg. A loading dose of 4 mg/kg would result in a level of greater than or equal to 5 micrograms/ml in 92% of the patients. After this study, a 4 mg/kg loading dose was initiated at our institution. Peak and trough concentrations at steady state were compared in 50 patients receiving a loading dose and 40 patients who had not received a loading dose. No significant differences were found in peak or trough concentrations after three or more doses, verifying that a loading dose does not affect steady-state concentrations. Because gentamicin toxicities are related to accumulation over time, whereas therapeutic efficacy may be related to early attainment of therapeutic peak serum concentrations, we recommend a loading dose of 4 mg/kg in all neonates beginning gentamicin therapy.