Abstract
Renal toxicity of aminoglycosides seems to be less frequent in newborn infants compared to adults.In 14 infants kinetic parameters of gentamicin were determined using an open three compartment body model. According to the lower glomerular filtration rate the β-elimination phase is longer in the newborn infant compared to adults,while the γ-elimination phase is quite similar to adult values. The calculated drug accumulation in the deep compartment (kidney) under steady state conditions is lower in newborns compared to infants.The Q-tissue:Q-body ratio is 0.38 in the newborn and 0.53 in older infants.The excretion of urinary enzymes of tubular origin, that is the brush border associated AAP (alanine-aminopeptidase),GGT (γ-glutamyl-transpeptidase) and the lysosomal NAG (Nacetyl-β-D-glucosaminidase),β-glucuronidase were determined in 74 healthy children and 14 gentamicin treated ones. If related to the body surface the excretion of these enzymes is lower in healthy newborn infants compared to older ones. But during aminoglycoside-therapy the increase of AAP is less pronounced in newborn infants especially in prematures if compared to adult values. After therapy the AAP excretion decreases to normal The calculated rate of this decrease takes place in a similar fashion like the release of drug from the kidney (γ-elimination phase).There may be a lower renal accumulation of aminoglycosides in newborn infants,which can be explained by the morphometric and functional characteristics of the newborn kidney.
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Heimann, G. Evaluation of aminoglycoside-induced nephrotoxicity in the newborn. Pediatr Res 18, 806 (1984). https://doi.org/10.1203/00006450-198408000-00086
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DOI: https://doi.org/10.1203/00006450-198408000-00086