Gentamicin Pharmacokinetics in Neonates Undergoing Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy.

IF 3.4 3区医学 Q1 PEDIATRICS

Pediatric Drugs Pub Date : 2024-10-24 DOI:10.1007/s40272-024-00661-7

Mamta Naik, Emily Warden, Rick Pittman, Lakshmi Katakam

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引用次数: 0

Abstract

Purpose: The purpose of this study was to review the pharmacokinetic profile of gentamicin among neonates with hypoxic ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH) treatment.

Methods: This was a retrospective study of neonates with HIE undergoing TH in the neonatal intensive care unit who received gentamicin between 2009 and 2014. Demographic information, diagnoses, laboratory test results, and medication administration and monitoring information were collected, and data were analyzed using SciPy.

Results: A total of 57 neonates were analyzed. The median birth weight was 3.25 kg (interquartile range [IQR] 2.8-3.68), and median gestational age was 39 weeks (IQR 38-40). An elevated gentamicin trough level (defined as > 2 mg/L) was observed in 61% (35/57) of neonates. Half of the neonates (49%) had multiple gentamicin trough levels obtained, and 4% of the neonates were switched to an alternate agent. There was a significant difference in the number of dosing interval changes in neonates with elevated gentamicin trough levels compared with those with therapeutic gentamicin trough levels (P < 0.001). Of the neonates with elevated gentamicin trough levels, 14% (5/35) failed their hearing screen (P = 0.389).

Conclusions: Neonates with HIE undergoing TH may have an altered pharmacokinetic profile, requiring multiple blood draws so medication levels can be monitored and doses adjusted. Traditional gentamicin dosing regimens may not be ideal for this patient population, and further guidance is required for alternative treatment regimens.

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因缺氧缺血性脑病而接受治疗性低温的新生儿的庆大霉素药代动力学。

目的：本研究旨在回顾缺氧缺血性脑病（HIE）新生儿接受治疗性低温（TH）治疗时庆大霉素的药代动力学特征：这是一项回顾性研究，研究对象是2009年至2014年期间在新生儿重症监护室接受治疗性低温的缺氧缺血性脑病新生儿，他们都接受了庆大霉素治疗。收集了人口统计学信息、诊断、实验室检查结果、用药和监测信息，并使用 SciPy 对数据进行了分析：结果：共分析了 57 名新生儿。出生体重中位数为 3.25 千克（四分位数间距 [IQR] 2.8-3.68），胎龄中位数为 39 周（IQR 38-40）。61%的新生儿（35/57）观察到庆大霉素谷值水平升高（定义为 > 2 mg/L）。半数新生儿（49%）获得了多个庆大霉素谷值，4%的新生儿转用了其他药物。庆大霉素谷值水平升高的新生儿与庆大霉素治疗谷值水平升高的新生儿在给药间隔更换次数上存在明显差异（P 结论：庆大霉素治疗谷值水平升高的新生儿与庆大霉素治疗谷值水平升高的新生儿在给药间隔更换次数上存在明显差异：接受TH治疗的HIE新生儿的药代动力学特征可能会发生改变，因此需要多次抽血，以便监测药物水平并调整剂量。传统的庆大霉素给药方案可能并不适合这类患者，因此需要进一步指导替代治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Drugs PEDIATRICS-PHARMACOLOGY & PHARMACY

CiteScore

7.20

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Pediatric Drugs promotes the optimization and advancement of all aspects of pharmacotherapy for healthcare professionals interested in pediatric drug therapy (including vaccines). The program of review and original research articles provides healthcare decision makers with clinically applicable knowledge on issues relevant to drug therapy in all areas of neonatology and the care of children and adolescents. The Journal includes: -overviews of contentious or emerging issues. -comprehensive narrative reviews of topics relating to the effective and safe management of drug therapy through all stages of pediatric development. -practical reviews covering optimum drug management of specific clinical situations. -systematic reviews that collate empirical evidence to answer a specific research question, using explicit, systematic methods as outlined by the PRISMA statement. -Adis Drug Reviews of the properties and place in therapy of both newer and established drugs in the pediatric population. -original research articles reporting the results of well-designed studies with a strong link to clinical practice, such as clinical pharmacodynamic and pharmacokinetic studies, clinical trials, meta-analyses, outcomes research, and pharmacoeconomic and pharmacoepidemiological studies. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Pediatric Drugs may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.