Abstract
Gentamicin is extensively used in the neonatal period but preliminary evidence indicates it can cause the displacement of bilirubin from albumin (Odell, Ann. N.Y. Acad. Sci. 226: 225, 1973). Addition of gentamicin at therapeutic concentrations to model sera and human serum from jaundiced infants caused dissociation of bilirubin from alburmin similar to salicylate. This was reflected by shifts in the absorption curves to lower wave lengths and by adsorption to red cells and mitochondria. There was also a very strong correlation between the amount of displacement by salicylate and gentamicin in pre-exchange blood samples, (r=.94, p<.001 n=18). On a molar basis gentamicin is more effective than salicylate and sulfonamides in displacing bilirubin from albumin.
Injection (i.p.) of gentamicin in jaundiced Gunn rats at doses of 3, 3.5 and 6μg/kg was associated with 28, 38 and 52% decreases, respectively, in the serum bilirubin concentrations at 30 min and 19, 28, 35% decreases at 60 min. Animals injected with either saline, or kanamycin (7.5 and 15 μg/kg) exhibited only a 5% decrease in their serum bilirubins at 30 and 60 min.
These results suggest that the use of gentamicin in infants with neonatal hyperbilirubinemia may increase the risk of bilirubin encephalopathy.
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Cukier, J., Seungdamrong, S., Odell, J. et al. THE DISPLACEMENT OF ALBUMIN-BOUND BILIRUBIN BY GENTAMICIN. Pediatr Res 8, 399 (1974). https://doi.org/10.1203/00006450-197404000-00354
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DOI: https://doi.org/10.1203/00006450-197404000-00354