AMIKACIN DOSES IN NEONATES SHOULD BE INDIVIDUALISED

In some institutions, amikacin has become the aminoglycoside of choice for suspected sepsis in neonates. The

pharmacokinetics of IV amikacin (loading dose 10 mg/kg, then 7.5 mg/kg every 12 hours) were investigated in 18

neonates (5 weighing lOOOg or less, 13 over lOOOg) with suspected or proven infections. Lighter infants were

significantly older (4 over 7 days) than the heavier infants (11 under 7 days). The mean trough serum amikacin level

in smaller infants (16.6 Mgfml) was significantly higher than in larger infants (6.4 1-Lgfml). Peak levels over 40 Mgfml

occurred in 3 of the smaller, and 4 of the larger infants. Toxic peak (over 35 Mg/ml) or trough (over 10 Mg/ml) levels,

with possible risk of nephrotoxicity andjor ototoxicity, occurred in 70% and 29% of determinations in smaller and

larger infants, respectively. It therefore seems that the recommended dosage of amikacin for neonates may not be

appropriate for low birthweight infants. Thus, individually monitored amikacin doses are recommended for neonates.

Philips .. I.B. ct a!.: Pediatric Pharmacology 2: 121 (No 2. 1982)

14 lNPHARMA 5 Mar 1983 0156-2703/83/0305-0014/0$01 .00/0 © ADlS Press