title: Outcomes of a new dosage regimen of amikacin based on pharmacokinetic parameters of Korean neonates.
abstract: OBJECTIVE
  Study results indicating improved neonatal amikacin therapy outcomes through the use of a dosage regimen tailored to population-specific pharmacokinetic parameters are presented.
  
  
  METHODS
  In a retrospective analysis, outcomes of amikacin therapy were evaluated in two groups of Korean neonates: group 1 (n = 107), who received amikacin according to standard neonatal dosing recommendations and empirical dosing guidelines, which often resulted in a need for dosage adjustments; and group 2 (n = 74), who were treated under a revised dosage regimen derived from pharmacokinetic data on group 1 and taking into account unusually high interpatient variability in amikacin clearance among Korean newborns relative to Caucasian populations. The influences of postconceptional and postnatal age on amikacin pharmacokinetics were also evaluated.
  
  
  RESULTS
  Relative to standard and empirical amikacin dosing, the revised dosage regimen resulted in a significantly higher percentage of neonates achieving peak concentrations within the target range of 20-30 mg/L (81.3% in group 2 versus 50.7% in group 1, p < 0.001). The percentage of neonates with a peak concentration of <20 mg/L was significantly lower in group 2 (3.8%) versus group 1 (21.6%, p < 0.001), as were the proportion of neonates with peak concentrations of >30 mg/L (15.0% versus 27.6%, p < 0.001) and the need for dosage adjustment by a pharmacist (31.6% versus 59.7%, p = 0.056).
  
  
  CONCLUSIONS
  A new amikacin dosing regimen based on the pharmacokinetic parameters of Korean neonates was effective in achieving peak and trough amikacin concentrations within the target range.
authors.affiliation: Sook Hee An, M.S., is a Ph.D. candidate, College of Pharmacy and Pharmaceutical Sciences, Ewha Womans University, and Pharmacist, Department of Pharmacy, Asan Medical Center, Seoul, Korea. Jae Yeon Kim, Ph.D., is Director, Department of Pharmacy, Asan Medical Center. Hye Sun Gwak, Pharm.D., Ph.D., is Professor, College of Pharmacy and Pharmaceutical Sciences, Ewha Womans University.
authors.forename: Sook Hee
authors.initials: SH
authors.lastname: An
authors.forename: Jae Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Gwak
mesh_terms: D000367:Age Factors; D000583:Amikacin / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001034:Apgar Score; D044466:Asian People; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D010607:Pharmacy Service, Hospital / Q000458:organization & administration; D058996:Quality Improvement; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin