Abstract
Dosages of I.V. gentamicin (G) seek to maintain peak serum levels of 4-12 mcq/ml. Recommendations are that pre-dose (PrD) levels remain below 2 mcq/ml to avoid nephrotoxicity. We obtained serum G levels in premature and stressed neonates with gestational ages (GA) from 24-40+ weeks following IV infusion of standard dosages (2.5 mg/kg).
G. Was administered by IV or IA infusion over 20 minutes PrD levels were obtained by heel puncture one half hour before the next dose (ie after 5 calculated half lives (t 1/2). T 1/2 of G was calculated for each infant using standard pharmacokinetic formulae. Post dose levels were obtained 20 minutes following completion of the infusion.
Results are listed in the table grouped by G.A. The percentage figures reflect the incidence of PrD levels greater than 2 mcq/ml.
All post dose levels were within acceptable limits. Our findings confirm that dosage intervals frequently need altering in premature and stressed neonates of all G.A., if PrD are to be kept below 2 μg/ml. Schedule alterations should be based upon each infants pharmacokinetic parameters.
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Jenkins, S., Bolam, D., Hyde, W. et al. 1333 MONITORING GENTAMICIN DOSAGES IN PREMATURE NEONATES. Pediatr Res 15 (Suppl 4), 665 (1981). https://doi.org/10.1203/00006450-198104001-01362
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DOI: https://doi.org/10.1203/00006450-198104001-01362