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Extended-interval gentamicin administration in neonates: an over-simplified approach

Journal of Perinatology volume 36, page 1027 (2016)Cite this article

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We read with interest the paper by El-Chaar et al on a simplified approach to extended interval dosing (EID) of gentamicin in neonates.1 We are pleased to see others recognize the benefits of using EID in neonates and approaching it in such a practical way. Our present practice is to adjust dosing intervals in neonates on EID using a single level drawn at 22 h post dose; we have validated this method in neonates less than and greater than 7 days of age and have found it a very effective and practical method.2, 3, 4

Our first concern with the authors’ approach is the very broad gestational age groupings. Maturation of nephrons occurs between 34 to 36 weeks, and the rate at which neonatal renal function increases ex utero is inversely related to the gestational age at birth.4, 5, 6 Because of this, the broad gestational age categories used in this study may not accurately account for these differences in renal function. For the authors’ dosing recommendation to be extended to infants of all gestational ages (GA), a much more detailed examination using smaller GA subgroups is required. The authors’ own data showing a higher rate of Cmin values >2 mg l−1 in Group 1 supports this.

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References

  1. El-Chaar GM, Supaswud-Franks T, Venugopalan L, Kohn N, Castro-Alvarez S . Extended-interval gemtamicin administration in neonates: a simplified approach. J Perinatol 2016; 36: 660–665.

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  2. Dersch-Mills D, Akierman A, AlShaikh B, Sundaram A, Yusuf K . Performance of a dosage individualization table for extended interval gentamicin in neonates beyond the first week of life. J Matern Fetal Neonata Med 2016; 29: 1451–1456.

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Authors and Affiliations

  1. Department of Medicine, Alberta Health Services, Calgary, AB, Canada

    D Dersch-Mills, B AlShaikh, A Akierman & K Yusuf

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  1. D Dersch-Mills
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  2. B AlShaikh
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  3. A Akierman
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  4. K Yusuf
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Correspondence to D Dersch-Mills.

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Dersch-Mills, D., AlShaikh, B., Akierman, A. et al. Extended-interval gentamicin administration in neonates: an over-simplified approach. J Perinatol 36, 1027 (2016). https://doi.org/10.1038/jp.2016.141

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