Performance of a dosage individualization table for extended interval gentamicin in neonates beyond the first week of life. (2nd May 2016)

• Record Type: Journal Article
• Authors: Dersch-Mills, Deonne; Akierman, Albert; Alshaikh, Belal; Sundaram, Arun; Yusuf, Kamran
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 29:Number 9(2016)
• Page Start: 1451
• Page End: 1456
• Publication Date: 2016-05-02
• Subjects: Aminoglycosides – administration and dosage -- aminoglycosides – pharmacokinetics -- Infant – newborn; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2015.1051021
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective : To assess the performance of a gentamicin dosing table for the individualization of extended-interval dosing (EID) in a neonatal population >7 days old. Methods : A prospective observational study was carried out on gentamicin concentrations achieved using a dosing table in neonates >7 days old. Neonates were given 5 mg/kg IV gentamicin; then a table using 22 h post-first dose gentamicin concentrations was used to individualize dosing intervals. Pre- and post-serum gentamicin concentrations were measured and used to calculate the true peak and trough concentrations achieved. Results : Use of the table resulted in dosing intervals that provided appropriate peak (mean 9.8 ± 1.8 mg/L) and trough (mean 0.6 ± 0.3 mg/L) concentrations in all neonates ( n = 38). All trough concentrations were <2 mg/L, 83% were <1 mg/L. The majority of peak concentrations were in the usual target range (87%, 5–12 mg/L), with a few being in a higher, although likely safe range (13%, 12.1–15.7 mg/L). Conclusions : Use of this dosing table to individualize extended-interval gentamicin dosages in neonates >7 days old resulted in appropriate peak and trough concentrations in all neonates studied. This allows appropriate extended-interval aminoglycoside dosages in neonates early in treatment.