RESUMO
BACKGROUND: When pediatric patients with normal renal function were given the recommended keep-up amount of aminoglicocide for the use, they showed a better clinical symptom not indicating the poisonous without checking serum concentrations. We studied this subject against the patients who used Netimilcin in order to know if the blood creatinine significantly increases in a clinic and if it reaches the maximum and minimum concentrations without adjusting the amount and the symptom of infection and the result get better. METHODS: We picked the maximum concentration of drugstuffs 30 minutes after injection and its minimum just prior to the next injection within 24~32 hours with a vein injection of 2 mg/kg/dose Netilmicin with the 8 hours difference against 16 patients at the age between 3 months and 14 years. We measured the blood creatinine at the beginning of the treatment and at the closing, and we decided the medicine serum concentration with TDX system and we counted the result of Pharmaco-kinetic parameter with Simkin PC clinical Database system. To check the patients' result of better clinical conditions, leukocyte values and the temperature were measured 72 hours after the treatment. The analysis of statistics was performed with the use of paired t-test. RESULTS: The average age of 16 patients shows 3.5+/-3.2, average weight 15.2+/-8.5 kg, the leukocyte value first 14.9+/-6.6X10X10X10/mm3, and 72 hours after the treatment it shows 6.6+/-1.9X10X10X10/mm3, average temperature fell from 37.7+/-1 celsius into 36.3+/-0.4 celsius. The average drug amount taken in case of patients showed 2.06+/-0.4, the average treatment period was 7.6+/-2.3 days, the maximum serum concentration shows 5.5+/-1.1 mg/mL, the minimum concentration shows 0.5+/-0.3 mg/mL. The average blood creatinine was first 0.52+/-0.19 mg/mL, and at closing 0.46+/-0.11 mg/dL (P=0.209). The minimum concentration didn't show more than 2 mcg/mL, the blood creatinine didn't increase showing 0.5 mg/mL(P=0.201). CONCLUSION: At the result of checking the medicine concentration of Netilmicin in pediatric patients in our clinic, there is no detecting the betterment of the clinical symptom owing to the decrease of the values of leukocyte. There was no necessity to adjust the amount of medicine from the beginning to the end as there was no sign of change of blood creatinine. In view of this result, we can understand that we don't need the regular examination of the medicine concentration about the aminoglicocide from Korean pediatric patients with normal renal function.
Assuntos
Humanos , Creatinina , Leucócitos , Netilmicina , Pediatria , VeiasRESUMO
It has been reported that theophylline clearance is lower in Korean infants than in Americans, suggesting that dose requirements for theophylline in Korean infants will be 1ower than those in Americans. Therefore, we reviwed patients charts retrospectively to formulate the new theophylline dosing equation appropiate to Korean infants. We reviewed patient charts of 111 asthmatic infants who received intravenous aminophy1line and oral theophylline in Wa1lace Memorial Baptist Hospital. We set the therapeutic serum concentration at 5-15microgram/ml in Korean infants based on response rate to theophylline therapy, which is supported by National Institute of Health Expert Panel Recommendations. Doses required to achieve a therapeutic serum concentration increased with age. The mean dose among the infants less than 4 months of age was 578+/-154mg/kg/day and increased to 10.12+/-1.78mg/kg/day after 8 months (p<0.0001). The relationship between age and dosage requirements can be expressed by the least squares determination of the linear regression :Dose (mg/kg/day) = 557 + 0.14 X (age in weeks). The coefficient of correlation for this relationship is 0.67(p<0.0001). Half-lives of elimination among the infants studied correspondingly decreased with age. In conclusion, this study showed that the relationship between age and dosage requirements in Korean infants may be different from those in Americans. Therefore, we strongly suggest that it is required to formulate a new theophylline dosing equation appropriate for Korean infants through well-designed prospective studies.