Effects of Co-Administration of Ibuprofen-Lysine on the Pharmacokinetics of Amikacin in Preterm Infants during the First Days of Life

Allegaert, Karel; Cossey, Veerle; Langhendries, Jean Paul; Naulaers, Gunnar; Vanhole, Christine; Devlieger, Hugo; Overmeire, Bart Van

doi:10.1159/000079618

Cited by 66 publications

(66 citation statements)

References 16 publications

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“…We found a positive correlation between amikacin clearance and GA, as has been described for aminoglycosides (18,20,(35)(36)(37)(38)(39). The absolute value of amikacin clearance (0.61 ml/kg per min) is comparable to previously reported values (0.52 to 0.6 ml/kg per min (17)(18)(19)40). Also, the distribution volume of amikacin was similar to previously reported values of 0.58 L/kg (18) and 0.59 L/kg (17).…”

Section: Discussionsupporting

confidence: 90%

“…The absolute value of amikacin clearance (0.61 ml/kg per min) is comparable to previously reported values (0.52 to 0.6 ml/kg per min (17)(18)(19)40). Also, the distribution volume of amikacin was similar to previously reported values of 0.58 L/kg (18) and 0.59 L/kg (17). Aminoglycoside clearance increases with rising postnatal age (39 -41), which is similar to the positive correlation between GFR and postnatal age (16,27).…”

Section: Discussionsupporting

confidence: 89%

“…Previously, the clearance of amikacin was used as a marker of GFR in neonates (17)(18)(19)(20) because aminoglycoside clearance correlates well with GFR (21). Amikacin is often used in neonates in whom perinatal infection is suspected, and amikacin levels are routinely monitored.…”

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confidence: 99%

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Impact of Gestational Age and Birth Weight on Amikacin Clearance on Day 1 of Life

Schreuder

Wilhelm²,

Bökenkamp

et al. 2009

Clinical Journal of the American Society of Nephrology

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Background and objectives: Intrauterine growth restriction (IUGR) and prematurity are associated with a low nephron endowment. It can therefore be expected that neonates who are born premature and/or after IUGR have a lower GFR. Measurement of GFR in neonates is difficult, but the clearance of amikacin has been proven to be a reliable marker. We hypothesized that amikacin clearance is lower after IUGR or premature birth as a marker of low nephron endowment.Design, setting, participants, & measurements: Amikacin clearance was retrospectively analyzed in 161 neonates who received amikacin within the first 24 h of life. Using the MW/Pharm computer program, a population one-compartment model was calculated. The mean population pharmacokinetic parameters were individualized for each patient according to the maximum a posteriori Bayesian fitting method and provided the amikacin clearance.Results: Our results show that birth weight z score and gestational age are correlated with the clearance of amikacin (partial correlation coefficient 0.159, P ‫؍‬ 0.046, and 0.396, P < 0.001, respectively), after correction for other factors.Conclusions: We conclude that renal clearance on the first day of life is lower in neonates with a lower gestational age and/or birth weight z score. This indicates that both prematurity and IUGR impair GFR on the first day of life.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 89%

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Impact of Gestational Age and Birth Weight on Amikacin Clearance on Day 1 of Life

Schreuder

Wilhelm²,

Bökenkamp

et al. 2009

Clinical Journal of the American Society of Nephrology

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“…Amikacin (Amukin, 50-mg/ml pediatric vial; Bristol Myers Squibb Belgium) was given as an intravenous infusion over 20 min via syringe driver (SIMS; Graseby, Watford, United Kingdom). Blood samples for TDM were collected by arterial line or venous puncture just before ("trough") and 1 h after the initiation of administration ("near peak") of the second dose of amikacin, approximately 40 min after the 20-min intravenous infusion (1,2).…”

Section: Methodsmentioning

confidence: 99%

“…The safety and effectiveness of extended interval dosing of aminoglycosides in neonates has been reviewed (19). After the first few days of postnatal life, size, postmenstrual age (PMA), renal function, and ventilation contribute to renal drug clearance variability in neonates and subsequent serum concentration (1,2,3).…”

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Cerebrospinal Fluid Compartmental Pharmacokinetics of Amikacin in Neonates

Allegaert

Scheers²,

Adams³

et al. 2008

Antimicrob Agents Chemother

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The incidence of early-onset bacterial infection in the neonate varies from 0.5 to 1% of the total number of deliveries but is significantly higher in preterm neonates, where infection is causally linked with premature delivery in ca. 50% of cases (14). Late-onset, nosocomial bacterial infections occur in a significant number of preterm and term neonates during their stay in the neonatal intensive care unit. Bacteremia, pneumonia, necrotizing enterocolitis, and meningitis are the most frequent loci for infection in neonates. Empirical treatment for suspected infection in early neonatal life consists of combination therapy based on a time-dependent (beta-lactamase) and a concentration-dependent (aminoglycoside) antibiotic coverage (e.g., Streptococcus agalactiae and Escherichia coli), whereas in late neonatal life coagulase-negative Staphylococcus should also be covered.The bactericidal effectiveness of amikacin is linked to intermittent, discontinuous peak concentrations, whereas renal side effects and ototoxicity relate to the average serum concentration that contributes to the saturation of renal and cochlear cell binding sites. The combination of bactericidal effect and toxicity data has resulted in the concept of administration of relative larger doses with extended dosing intervals between consecutive doses. The safety and effectiveness of extended interval dosing of aminoglycosides in neonates has been reviewed (19). After the first few days of postnatal life, size, postmenstrual age (PMA), renal function, and ventilation contribute to renal drug clearance variability in neonates and subsequent serum concentration (1, 2, 3).The effectiveness of amikacin for treating meningitis depends on the concentrations in the central nervous system, and this compartment is separated from the blood by the bloodbrain barrier (BBB). Access of aminoglycosides to the central nervous compartment is limited in healthy children and adults (8,26,28), but cerebrospinal fluid (CSF) aminoglycoside exposure after systemic administration is more extended in children with meningitis than in those without meningitis (24). Correlations between antibiotic concentration and CSF glucose content, CSF leukocytosis, or CSF protein concentrations have been investigated (12,13,15,26,27). Ototoxicity relates to the mean aminoglycoside concentration in the central nervous system compartment, but a genetic predisposition to develop aminoglycoside-related ototoxicity has also been documented (4,10,17,23).Observations on maturational amikacin CSF disposition in neonates are therefore of relevance (17,19). However, data on amikacin CSF concentrations are limited in neonates, and amikacin CSF time-concentration profiles in preterm neonates have not been reported (9). In the present study, time-concentration profiles of amikacin in serum and single CSF samples were collected to evaluate the relationship between serum and CSF concentration and to explore the impact of CSF inflammatory markers (leuko-, gluco-, and protidorhachia) on this relationship du...

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Amikacin

2007

Neonatal Formulary

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Effects of Co-Administration of Ibuprofen-Lysine on the Pharmacokinetics of Amikacin in Preterm Infants during the First Days of Life

Cited by 66 publications

References 16 publications

Impact of Gestational Age and Birth Weight on Amikacin Clearance on Day 1 of Life

Impact of Gestational Age and Birth Weight on Amikacin Clearance on Day 1 of Life

Cerebrospinal Fluid Compartmental Pharmacokinetics of Amikacin in Neonates

Amikacin

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