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Individualised dosing of amikacin in neonates: a pharmacokinetic/pharmacodynamic analysis
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
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2009 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 65, no 7, 705-713 p.Article in journal (Refereed) Published
Abstract [en]

To examine the pharmacokinetics of amikacin and its pharmacokinetic pharmacodynamic (PKPD) relationship in neonates. To develop an alternative dosing strategy for amikacin in neonates. A population PKPD analysis was performed using data collected from 80 neonates with gestational ages from 24 to 41 weeks. The final pharmacokinetic model analysed 358 amikacin concentrations. All neonates were > 72 hours postnatal age. Simulations were performed to develop a new dosing strategy. The final covariate model was clearance = 0.23 x (current weight/2)(0.691) x (postmenstrual age/40)(3.23) and volume of distribution = 0.957 x (current weight/2)(0.89). Following the logistic regression analysis of treatment failure, new amikacin target concentrations were estimated and used in development of an alternative dosing strategy. Simulation of a new dosing regimen yielded the following recommendations: 15 mg/kg at 36-h intervals, 14 mg/kg at 24-h intervals and 15 mg/kg at 24-h intervals for neonates a parts per thousand currency sign28 weeks, 29-36 weeks and a parts per thousand yen37 weeks postmenstrual age respectively.

Place, publisher, year, edition, pages
2009. Vol. 65, no 7, 705-713 p.
Keyword [en]
Amikacin, Neonates, Population pharmacokinetics, Pharmacodynamics
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-129022DOI: 10.1007/s00228-009-0637-4ISI: 000266814500008OAI: oai:DiVA.org:uu-129022DiVA: diva2:332465
Available from: 2010-08-05 Created: 2010-08-05 Last updated: 2017-12-12Bibliographically approved

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