Deonne Dersch-Mills1, Albert Akierman2,3, Belal Alshaikh2,3, Arun Sundaram2,3, Kamran Yusuf2,3. 1. a Pharmacy Services, Alberta Health Services, Calgary , Alberta , Canada . 2. b Department of Pediatrics, Division of Neonatology , Alberta Health Services , Calgary, Alberta , Canada , and. 3. c Cumming School of Medicine, University of Calgary , Calgary, Alberta , Canada.
Abstract
OBJECTIVE: To assess the performance of a gentamicin dosing table for the individualization of extended-interval dosing (EID) in a neonatal population >7 days old. METHODS: A prospective observational study was carried out on gentamicin concentrations achieved using a dosing table in neonates >7 days old. Neonates were given 5 mg/kg IV gentamicin; then a table using 22 h post-first dose gentamicin concentrations was used to individualize dosing intervals. Pre- and post-serum gentamicin concentrations were measured and used to calculate the true peak and trough concentrations achieved. RESULTS: Use of the table resulted in dosing intervals that provided appropriate peak (mean 9.8 ± 1.8 mg/L) and trough (mean 0.6 ± 0.3 mg/L) concentrations in all neonates (n = 38). All trough concentrations were <2 mg/L, 83% were <1 mg/L. The majority of peak concentrations were in the usual target range (87%, 5-12 mg/L), with a few being in a higher, although likely safe range (13%, 12.1-15.7 mg/L). CONCLUSIONS: Use of this dosing table to individualize extended-interval gentamicin dosages in neonates >7 days old resulted in appropriate peak and trough concentrations in all neonates studied. This allows appropriate extended-interval aminoglycoside dosages in neonates early in treatment.
OBJECTIVE: To assess the performance of a gentamicin dosing table for the individualization of extended-interval dosing (EID) in a neonatal population >7 days old. METHODS: A prospective observational study was carried out on gentamicin concentrations achieved using a dosing table in neonates >7 days old. Neonates were given 5 mg/kg IV gentamicin; then a table using 22 h post-first dose gentamicin concentrations was used to individualize dosing intervals. Pre- and post-serum gentamicin concentrations were measured and used to calculate the true peak and trough concentrations achieved. RESULTS: Use of the table resulted in dosing intervals that provided appropriate peak (mean 9.8 ± 1.8 mg/L) and trough (mean 0.6 ± 0.3 mg/L) concentrations in all neonates (n = 38). All trough concentrations were <2 mg/L, 83% were <1 mg/L. The majority of peak concentrations were in the usual target range (87%, 5-12 mg/L), with a few being in a higher, although likely safe range (13%, 12.1-15.7 mg/L). CONCLUSIONS: Use of this dosing table to individualize extended-interval gentamicin dosages in neonates >7 days old resulted in appropriate peak and trough concentrations in all neonates studied. This allows appropriate extended-interval aminoglycoside dosages in neonates early in treatment.
Authors: J Ibrahim; D Maffei; G El-Chaar; S Islam; S Ponnaiya; A Nayak; W Rosenfeld; N Hanna Journal: J Perinatol Date: 2016-08-18 Impact factor: 2.521