受胎後週数を考慮した腎排泄型薬剤における新生児薬用量推定

概要

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The aim of the present study was to derive an equation for estimating doses of renal-excretion drugs in neonates based on clearance ratios for neonates and adults as well as in consideration of postconceptional age (PCA).The following equation was derived for the estimation of neonatal doses taking PCA into account :DN=DA·(1/fuA+(1-fuA)PN/PA)(0.23*(CWT/2)0.691*(PCA/40)3.23/4.9)where D,fu,P,and CWT represent the dose,free fraction of drug in plasma,serum protein level,and current weight,respectively.The subscripts N and A indicate neonate and adult,respectively.We examined the validity of this equation using 2 renally-excreted antibiotics,arbekacin sulfate (ABK) and vancomycin chloride (VCM) as examples.For the evaluation,we compared the neonatal doses derived using our equation and Crawford's equation.The established dose for each PCA based on a population parameter was used as the standard.The predictive accuracy of our equation was significantly higher than that of Crawford's equation for neonates at gestational weeks 25,30,and 35.In conclusion,our findings suggest that a general equation taking PCA into account would be useful for calculating antibiotic doses in neonates.
日本医療薬学会の論文