Individualising netilmicin dosing in neonates.
OBJECTIVE
The aim of this study was develop an optimal dosing regimen for netilmicin in neonates.


METHODS
This was a population pharmacokinetic study in 97 neonates aged from 2 to 28 days after the due date who were being treated with netilmicin for suspected sepsis. The model was used to simulate dosing regimens.


RESULTS
The principle factors influencing netilmicin clearance (CL) were postmenstrual age (PMA) and current body weight (CWT), and the principal determinant of volume of distribution (V) was CWT. The final covariate model was CL = 0.192 x (CWT/2)(1.35) x (PMA/40)(1.03), V = 1.5 x (CWT/2)(0.3). The optimal dosing was 5 mg/kg ever 36 h, 5 mg/kg every 24 h, 6 mg/kg every 24 h and 7 mg/kg every 24 h for neonates < or =27, 28-30, 31-33 and > or =34 weeks PMA, respectively.


CONCLUSIONS
Individualisation of netilmicin dosing in neonates requires adjustment of dose by body weight, and dosing interval by both PMA and CWT.
Sherwin
Catherine M T
CM
Department of Women's and Child Health, Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin, New Zealand. catherine.sherwin@stonebow.otago.ac.nz
Broadbent
Roland S
RS
Medlicott
Natalie J
NJ
Reith
David M
DM
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001034:Apgar Score; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D008499:Medical Records; D008657:Metabolic Clearance Rate; D008954:Models, Biological; D009428:Netilmicin / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy* / Q000378:metabolism
D000900:Anti-Bacterial Agents; D009428:Netilmicin