Once- Versus Twice-daily Gentamicin Dosing in Neonates ≥34  Weeks' Gestation: Cost-effectiveness Analyses

Thureen, Patti J.; Reiter, Pamela D.; Gresores, A; Stolpman, Nancy M.; Kawato, Kerry; Hall, Daniel M.

doi:10.1542/peds.103.3.594

Cited by 80 publications

(60 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Increasing the gentamicin dose to 4-5 mg/kg and administering it once daily has been suggested [14][15][16]. This dose yields peak and trough concentrations which are 5-12 and <2 μg/ml respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Formerly, gentamicin was administered at a dose of 2.5 mg/kg every 12 h [12]. Later, it appeared that once-daily gentamicin dosing of 4-5 mg/kg yields higher peak and lower trough gentamicin concentration than twice-daily dosing [13][14][15][16] (for review see Rao et al [17] and Miron [18]). Recently, administering 5 mg/kg gentamicin and extending the dosing interval to 36-48 h has been recommended [19][20][21][22].…”

Section: Gentamicinmentioning

confidence: 99%

See 1 more Smart Citation

Clinical pharmacokinetics of aminoglycosides in the neonate: a review

Pacifici

2008

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Background Sepsis is common in neonates and is a major cause of morbidity and mortality. Sixty percent of preterm neonates receive at least one antibiotic, and 43% of the antibiotics administered to these neonates are aminoglycosides. The clearance (Cl), serum half-life (t 1/2 ), and volume of distribution (Vd) of aminoglycosides change during the neonatal life, and the pharmacokinetics of aminoglycosides need to be studied in neonates in order to optimise therapy with these drugs. Objective The aim of this work is to review the published data on the pharmacokinetics of aminoglycosides in order to provide a critical analysis of the literature that can be a useful tool in the hands of physicians. Methods The bibliographic search was performed electronically using PubMed, as the search engine, through July 11th, 2008. Firstly, a Medline search was performed with the keywords "pharmacokinetics of aminoglycosides in neonates" with the limit of "human". Other Medline searches were performed with the keywords "pharmacokinetics of … in neonates" followed by the name of the aminoglycosides: amikacin, gentamicin, netilmicin and tobramycin. In addition, the book Neofax: A Manual of Drugs Used in Neonatal Care by Young and Mangum (Thomson Healthcare, 2007) was consulted. Results The aminoglycosides are mainly eliminated by the kidney, and their elimination rates are reduced at birth. As a consequence Cl is reduced and t 1/2 is prolonged in the neonate as compared to more mature infants. The high body-water content of the neonate results in a large Vd of aminoglycosides as these drugs are fairly water soluble. Postnatal development is an important factor in the maturation of the neonate, and as postnatal age proceeds, Cl of aminoglycosides increases. Conclusion The maturation of the kidney governs the pharmacokinetics of aminoglycosides in the infant. Cl and t 1/2 are influenced by development, and this must be taken into consideration when planning a dosage regimen with aminoglycosides in the neonate. Aminoglycosides are fairly water soluble, and the larger water content of neonates yields a larger Vd in these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Gentamicinmentioning

confidence: 99%

Clinical pharmacokinetics of aminoglycosides in the neonate: a review

Pacifici

2008

Eur J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

“…9,49 For short courses of aminoglycosides, the ODD regimen proved to be the better strategy, with superior drug performance and reduced hospital costs. Extendedinterval administration of aminoglycosides requires less pharmacy preparation time and less nursing administration time.…”

Section: Discussionmentioning

confidence: 99%

Extended-Interval Aminoglycoside Administration for Children: A Meta-analysis

Contopoulos‐Ioannidis

et al. 2004

View full text Add to dashboard Cite

ABSTRACT.Background. There has been a longstanding debate regarding whether aminoglycosides should be administered on a multiple daily dosing (MDD) or once-daily dosing (ODD) schedule. Several unique characteristics of the aminoglycosides make ODD an attractive and possibly superior alternative to MDD. These include concentration-dependent bactericidal activity; postantibiotic effect, which allows continued efficacy even when serum concentrations fall below expected minimum inhibitory concentrations; decreased risk of adaptive resistance; and diminished accumulation in renal tubules and inner ear.Objective. To assess the relative efficacy and toxicity of ODD, compared with MDD, of aminoglycosides among pediatric patients.Study Selection. Randomized, controlled trials among children, evaluating the relative efficacy and toxicity of ODD versus MDD of aminoglycosides, with similar total daily doses in the compared arms, were selected.

show abstract

“…Extended interval dosing appears to be safe, is efficacious (28), is more cost-effective (29) and is associated with fewer morbidities, although long-term results from large numbers of babies have not been reported. We speculate that similar findings to the present study may exist with larger dosing with extended intervals; this has been shown to be associated with fewer failures to achieve peak levels without increasing trough levels (2,30).…”

Section: Discussionmentioning

confidence: 99%

Gentamicin in neonates at risk for sepsis – peak serum concentrations are not necessary

2012

Paediatrics and Child Health

View full text Add to dashboard Cite

Once- Versus Twice-daily Gentamicin Dosing in Neonates ≥34 Weeks' Gestation: Cost-effectiveness Analyses

Cited by 80 publications

References 15 publications

Clinical pharmacokinetics of aminoglycosides in the neonate: a review

Clinical pharmacokinetics of aminoglycosides in the neonate: a review

Extended-Interval Aminoglycoside Administration for Children: A Meta-analysis

Gentamicin in neonates at risk for sepsis – peak serum concentrations are not necessary

Contact Info

Product

Resources

About