[Appropriate usage of antibiotics by therapeutic drug monitoring].
Aminoglycosides are mainly distributed in the extracellular fluid, so when they are given to neonates who have a large amount of extracellular fluid, their distribution is increased. In our data, the volume of distribution (Vd) of Arbekacin in the neonates was twice that of the adults, 0.54 l/kg. Therefore, the dose per weight of aminoglycosides to the neonates should be increased more than to the adults. In the renal function of the neonates, differentiation of the nephron is completed within 36 weeks after conception, but it is functionally immature. In our data, renal drug excretion increased rapidly in the post-conceptional ages (PCAs) of 34-35 weeks. Consequently, we based the Arbekacin administration schedule for the neonates on the PCAs. There is excellent correlation between serum level of vancomicin (VCM) and dose x serum creatinine (Scr)/weight in the haemodialysis patients, suggesting that we can use weight and Scr to set the VCM administration schedule for these patients. We also established on administration schedule of Teicoplanin for the haemodialysis patients. In this article, we present the TDM analysis result of the antibiotics in our hospital.
Kokubun
Hideya
H
Department of Pharmacy, Kitasato University Hospital, Japan. kokubun@kitasato-u.ac.jp
Kimura
Toshimi
T
Yago
Kazuo
K
D000328:Adult; D000617:Aminoglycosides / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D001835:Body Weight; D003982:Dibekacin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D004334:Drug Administration Schedule; D016903:Drug Monitoring; D045604:Extracellular Fluid / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000378:metabolism; D010348:Patient Care Team; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000378:metabolism; D017334:Teicoplanin / Q000008:administration & dosage / Q000493:pharmacokinetics; D014640:Vancomycin / Q000008:administration & dosage* / Q000493:pharmacokinetics
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D003982:Dibekacin; D017334:Teicoplanin; D014640:Vancomycin; C031986:arbekacin