Article Text

PDF
PP 056
EXTENDED INTERVAL GENTAMICIN DOSING IN PRETERM INFANTS LESS THAN 35 WEEKS CORRECTED GESTATIONAL AGE
  1. Jarrid W R McKitrick1,
  2. Brad Bewick2,
  3. Robert Ariano2,
  4. Sheryl Zelenitsky3,
  5. Michael Narvey1,
  6. Geert W 't Jong4
  1. 1Health Sciences Centre
  2. 2St Boniface General Hospital
  3. 3University of Manitoba
  4. 4Children's Hospital Research Institute of Manitoba

Abstract

Objective To confirm that gentamicin 5 mg/kg/dose every 48 hours in neonates less than 35 weeks corrected gestational age (CGA) results in the majority of gentamicin serum trough levels within the range of 0.5–2 mg/L and peak levels within the range of 6–12 mg/L.

Design Prospective pharmacokinetic (PK) analysis.

Setting Two neonatal intensive care units and one intermediate care unit in two tertiary care centres. Patients: Neonates less than 35 weeks CGA who received empiric gentamicin for sepsis between March 10 and June 10, 2014 in whom at least one gentamicin serum level was measured. Methods: PK analysis was performed following implementation of empiric dosing for gentamicin of 5 mg/kg every 48 hours in neonates.

Results Mean Cl, t1/2 and V1 were 42±10 mL/kg/h, 10.0±1.8 h, and 0.58±0.09 L/kg, respectively (n=54). A one-compartment pharmacokinetic model best represented the data. The mean Cl of gentamicin at 24 h post dose was significantly lower in neonates.

Conclusions Gentamicin 5 mg/kg q48h results in serum post dose levels between 6–12 mg/L 98% of the time compared to 5% of the time for once daily doses of 2.5 or 3 mg/kg. Gentamicin doses of 5 mg/kg q48h resulted in serum pre levels less than 0.5 mg/L 82% of the time (48 h post dose) compared to 9% of the time for once daily doses (24 h post dose). Increased clearance with advanced PNA suggests the need for more frequent dosing in neonates >14 days of age.

  • ESDP

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.