Predictors of Trough Serum Gentamicin Concentrations in Neonates

Keyes, Pam S.; Johnson, Carolyn K.; Rawlins, Timothy D.

doi:10.1001/archpedi.1989.02150240041014

Cited by 9 publications

(7 citation statements)

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“…Thus, there may not have been important alterations in gentamicin clearance as has been shown in other reports. 61,62 Study Limitations Because this study was a retrospective analysis, the data were not collected concurrently with a data collection tool, and the data lack uniformity. In addition, the timing of plasma concentration sampling was not standardized around a particular dose or day and was not at steady state for some patients.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetic Outcomes of a Simplified, Weight‐Based, Extended‐Interval Gentamicin Dosing Protocol in Critically Ill Neonates

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetic Outcomes of a Simplified, Weight‐Based, Extended‐Interval Gentamicin Dosing Protocol in Critically Ill Neonates

et al. 2009

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“…The elimination rate constant (Ke) was 0.064±0.034 and 0.098±0.046 h -1 at gestational ages <32 and ≥37 weeks respectively; and Vd was 0.70±0.17 and 0.54±11 l/kg at the gestational ages of <32 and ≥37 weeks respectively [40]. The difference in Cl reflects the reduced clearance of tobramycin in preterm neonates [41][42][43]. The difference in Vd is primarily attributable to a higher percentage of body water in premature infants resulting in a higher Vd as tobramycin is fairly water soluble [41][42][43].…”

Section: Tobramycinmentioning

confidence: 99%

“…The difference in Cl reflects the reduced clearance of tobramycin in preterm neonates [41][42][43]. The difference in Vd is primarily attributable to a higher percentage of body water in premature infants resulting in a higher Vd as tobramycin is fairly water soluble [41][42][43]. Young and Mangum [7] suggest a dose of tobramycin similar to that of gentamicin given above.…”

Section: Tobramycinmentioning

confidence: 99%

Clinical pharmacokinetics of aminoglycosides in the neonate: a review

Pacifici

2008

Eur J Clin Pharmacol

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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.

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“…Many factors may influence trough aminoglycoside levels in neonates (gestational age, volume of distribution, clearance and half life). The most important seem to be gestational age and dose interval [ 10 , 14 , 15 ]. Chronological age with maturation of renal function and changes in body composition after birth may also be important [ 2 , 16 ].…”

Section: Discussionmentioning

confidence: 99%