Abstract:Objective: To analyze the cases who were given amikacin intravenously in the neonatal ward of Children's Hospital of Chongqing Medical University and to summarize the etiological basis, dose, efficacy, ototoxicity, and nephrotoxicity of amikacin for providing guidance for clinical medication of amikacin. Methods: A retrospective study described the clinical features of 104 neonates with amikacin intravenously admitted to the Neonatal Ward of the Children's Hospital of Chongqing Medical University from January 2013 to December 2018, including general information, etiological examination results, main diagnosis, amikacin usage, renal function, and telephone follow-up of their hearing situation after discharge. Results: Totally 104 neonates given amikacin intravenously were included in this study, with an average gestational age of (32±4) weeks, and a median birth weight of 1 395.00 (1 131.25, 2 190.00) g. Bloodstream infections, respiratory tract infections, intestinal infections, and intracranial infections were the main infection sites of patients treated with amikacin. Most of them had pathogenic evidence, including blood culture, sputum culture, urine culture, secretion culture, etc. The culture results were mainly multidrug-resistant Klebsiella pneumoniae and Escherichia coli. The average dose of amikacin was (14.97±1.94) mg/ (kg·d), and the average administration duration was (9.42±5.06) days. A total of 68 cases (65.4%) showed improvement in inflammation and clinical symptoms after treatment with amikacin. The renal function was monitored in use, and multivariate logistic regression analy sis was used. The results showed that there was no significant correlation between amikacin-related exposure variables and the occurrence of acute kidney injury. After discharge, the children's hearing situation was followed up. Only one case failed the hearing test and cochlear implantation was recommended. The remaining children had no abnormal hearing in life. Conclusion: Amikacin is mostly used in neonatal wards for patients with multi-drug resistant gram-negative bacteria infection. The dosage using, duration and frequency of amikacin are different according to the disease situation of the neonates. The plasma concentration should be monitored to ensure that trough concentration and peak concentration are within the safe range. In addition, in terms of nephrotoxicity, there is no significant correlation between amikacin-related exposure variables and the occurrence of acute kidney injury.
