Problems in administration techniques and dose measurement that influence accuracy of i.v. drug delivery

Reilly, Kathleen M.

doi:10.1093/ajhp/44.11.2545

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2005

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“…Finally, there are reports of substantial differences between prescribed and administered doses of drugs, including amikacin, in neonates, probably contributing to the estimated PK parameter variability and residual variance [38–40].…”

Section: Discussionmentioning

confidence: 99%

Limited predictability of amikacin clearance in extreme premature neonates at birth

Allegaert¹,

Anderson²,

Cossey³

et al. 2005

Brit J Clinical Pharma

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AimIdentify and quantify factors describing variability of amikacin clearance in preterm neonates at birth. MethodsPopulation pharmacokinetics of amikacin were estimated in a cohor t of 205 extreme preterm neonates [post conception age (PCA) 27.8, SD 1.8, range 24-30 weeks; weight 1.07, SD 0.34, range 0.45-1.98 kg, postnatal age < 72 h]. Covariate analysis included weight, PCA, Apgar score, prophylactic administration of a nonsteroidal antiinflammatory drug (NSAID) to the neonate, maternal indomethacin and betamethasone administration, and chorioamnionitis. ConclusionsSize and post-conception age are the major contributors to clearance variability in extreme premature neonates ( < 31 weeks PCA). The large (35% of total) unexplained variability in clearance reinforces the need for target concentration intervention to reduce variability in exposure to a safe and effective range.

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Section: Discussionmentioning

confidence: 99%