新生児,小児,肥満小児におけるTobramycinの母集団パラメータの算出とベイジアン法を用いた新生児への個別投与設計への適応

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The population pharmacokinetic parameters of tobramycin were estimated by the computer program NONMEM in 14 newborn infants, 6 children, and 5 obese children with normal renal function. All of them were administered tobramycin with i. v. drip infusionfor 30min.<BR>Two models were used to obtain the population pharmacokinetic parameters: in the first model, it is assumed that volume of distribution and clearance are directly proportional to the body weight (linear model), and the other is exponentially related to the body weight (power model). The values of the objective function obtained by the population pharmacokinetic analysis for all of the patients indicated that the power model appeared signif icantly superior to the linear model.<BR>The results were used prospectively to forecast tobramycin concentrations in newborn infants by the Bayesian method. Firstly, the most suitable sampling time for predictive performance of the Bayesian method with single sampling point was determined by comparing various sampling times (4, 8, 12 hr). The predictions of serum concentrations using the single point of 12 hr after a single dose were best fitted to the observed data in 7 newborn infants. Secondly, the Bayesian method was applied to the dosage regimen during the multiple dosing in another 5 newborn infants using the population pharmacokinetic parameters estimated by the power model. The predicted serum concentrations of tobramycin were in good agreement with the observed data.
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新生児,小児,肥満小児におけるTobramycinの母集団パラメータの算出とベイジアン法を用いた新生児への個別投与設計への適応

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