Once-a-day individualized amikacin dosing for suspected infection at birthbased on population pharmacokinetic models

Amikacin is widely used in the treatment of suspected or confirmed neonatal infections. However, dosage regimens are not well defined in this group of patients because of a wide inter-individual pharmacokinetic variability. A n individualized goal-oriented amikacin dosage design was applied using pop ulation pharmacokinetic data. A dosing chart was developed for neonates dur ing the first 2 days of life, by using population pharmacokinetic parameter values and USCPACK software. This dosing chart based on gestational age (G A) and body weight gives a once-a-day amikacin dosage regimen involving an injection every 24 h. Validation was performed in 57 neonates less than 2 d ays old, divided into three GA groups and prospectively treated using the d osing chart. Target peak serum levels of amikacin were obtained in 62-80% o f patients after the first dose and in 80-100% after the second dose, and t rough concentrations were obtained in 100%. This study has confirmed the ne ed for individualization of amikacin dosage regimens in neonates. Copyright (C) 2001 S. Karger AG, Basel.