Tobramycin sulfate elimination in premature infants

Arbeter, Allan M.; Saccar, Consuelo L.; Saccar, L.; Eisner, Susan; Sarni, Elaine; Yaffe, Sumner J.

doi:10.1016/s0022-3476(83)80799-9

Cited by 25 publications

(8 citation statements)

References 11 publications

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“…Kasik et al (1985) studied pre-term children and found a much stronger correlation between gentamicin t 1=2b and postconceptual age, compared with postnatal age. Similar results have been obtained with tobramycin (Arbeter et al, 1983). Since the t 1=2b for aminoglycosides is prolonged in newborns of postconceptual age less than 34 weeks, these patients should have their dosing interval lengthened or individual dose decreased, compared with full term infants.…”

Section: Glomerular Filtration Ratesupporting

confidence: 78%

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Role of biokinetics in risk assessment of drugs and chemicals in children

Zwart

Haenen

Versantvoort

et al. 2004

Regulatory Toxicology and Pharmacology

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Section: Glomerular Filtration Ratesupporting

confidence: 78%

“…Several studies have investigated the pharmacokinetics of aminoglycosides in preterm and term infants (Arbeter et al, 1983). Szefler et al (1980) demonstrated a decreasing t 1=2b for gentamicin with increasing gestational age in neonates less than 7 days of age (see Table 9).…”

Section: Glomerular Filtration Ratementioning

confidence: 99%

Role of biokinetics in risk assessment of drugs and chemicals in children

Zwart

Haenen

Versantvoort

et al. 2004

Regulatory Toxicology and Pharmacology

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“…Until further studies establish nontoxic trough concentrations in low-birthweight infants, it may be judicious to follow the present recommendations and, if necessary, increase the dose interval to 18 to 24 hours, 12 not only in infants under 1500 gm but also those with birthweights between 1500 and 2500 gm (<35 weeks of gestation). Szefler et al 25 observed that the predose (trough) concentration of gentamicin was greater than 2 mcg/ml in 91 % of 34 newborn infants less than 35 weeks of gestational age, and in 32 % of 40 infants more than 34 weeks of gestational age.…”

Section: Discussionmentioning

confidence: 99%

Serum Tobramycin Levels in Low- and Very Low-Birthweight Infants

Cordero¹,

Arwood²,

Hann³

et al. 1984

Amer J Perinatol

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This study was designed to evaluate the serum concentration of tobramycin sulfate following a 2.5-mg/kg intravenous infusion in 43 premature infants on days 1, 3, and 5 of age (therapy). Twenty premature infants weighing 1500 gm or less at birth and 23 others whose birthweights ranged from 1501 to 2500 gm made up the study population. Serum tobramycin levels were measured by an enzymatic immunoassay (EMIT) at one, four to six, and 12 hours after injection. Peak serum levels increased from day 1 (means, 5.2 +/- 2.2 mcg/ml) to day 3 (means, 6.1 +/- 2.6 mg/ml) and then remained unchanged at day 5 (means, 6.1 +/- 2.4 mg/ml). Approximately 40% of the study population presented trough levels above 2 mcg/ml on day 1 and over 70% on days 3 and 5. No evidence of renal toxicity or auditory dysfunction was observed. In light of the high trough levels observed during the first week of life in premature infants, it may be judicious to monitor serum tobramycin concentration and to decrease the dosage or to prolong the dose interval in order to maintain trough concentrations below 2 mcg/ml.

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“…Actually, this study revealed that the increase in the peak blood concentration of ABK was 2.40 ± 0.20 µg/mL per mg ABK per kg bodyweight, which was lower than that in adult males (4.28 µg/mL) 1 . On the other hand, the elimination half‐life of ABK is expected to be delayed in newborns and infants compared to adults because renal function in newborns and infants is not fully developed and the glomerular filtration rate is lower than that in adults 3 . A report states that pharmacokinetics based on the glomerular filtration rate depends on postconceptional age 4 .…”

Section: Discussionmentioning

confidence: 99%

“…1 On the other hand, the elimination half-life of ABK is expected to be delayed in newborns and infants compared to adults because renal function in newborns and infants is not fully developed and the glomerular filtration rate is lower than that in adults. 3 A report states that pharmacokinetics based on the glomerular filtration rate depends on postconceptional age. 4 However, in this study there was no apparent correlation between the half-life of ABK and the gestational age, birth weight, age in days after birth or postconceptional age.…”

Section: Discussionmentioning

confidence: 99%