Peak serum gentamicin (G) levels were measured by agar diffusion 30 minutes after completion of, and trough levels just prior to, intravenous G infusion (2.4±.1mg/kg) in 44 neonates aged 14 days or less (X̄ 5.5 days). Gestational ages (GA) ranged from 26-43 weeks (X̄ 34.4±.7 wks). Serum half-lives (T½), peaks, and troughs (X̄±SEM) in 23 non-azotemic infants [BUN<15mg% and/or Creatinine (Cr)<1mg%] are presented below:
In a group of 21 azotemic infants [BUN≥15mg%. and/or Cr≥1.0mg%.) T½'s and troughs were significantly elevated when compared with all non-azotemic infants:
Routine monitoring of serum G levels allows drug dosage and timing to be individualized and is particularly important in the azotemic or extremely premature neonate in whom the use of standard neonatal dosage regimens is most likely to produce excessive, potentially toxic, drug levels.
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Vaucher, Y., Larter, W. & Sieber, O. ELEVATED GENTAMICIN LEVELS IN PREMATURE/AZOTEMIC NEWBORNS. Pediatr Res 11, 422 (1977). https://doi.org/10.1203/00006450-197704000-00318