Clinical Pharmacokinetics of Gentamicin in Neonates

Pacifici, Gian Maria and Pacifici, Gian Maria (2017) Clinical Pharmacokinetics of Gentamicin in Neonates. International Journal of Pediatrics, 5 (3). pp. 4575-4599.

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Abstract

Gentamicin is a bactericidal aminoglycoside antibiotic, it inhibits the protein synthesis. Gentamicin is active against the majority of aerobic gram-negative bacilli such as Pseudomonas, Klebsiella and Escherichia coli. The gentamicin doses are 3 mg/kg once-daily for preterm newborns < 35 weeks of gestation and 4 mg/kg once-daily for newborns > 35 weeks of gestation. The monitoring of gentamicin serum concentration is recommended when infants are treated for 48 hours or more. The gentamicin peak concentration must be at least 8 times the minimum inhibitory concentration (MIC) to be bactericidal and the gentamicin trough concentration must be < 2 µg/ml to avoid ototoxicity and nephrotoxicity.Once-daily dosing of gentamicin (4 mg/kg), is preferred than twice-daily dose of 2.5 mg/kg gentamicin. A gentamicin loading dose (4 mg/kg), followed by once-daily dosing of 2.5 mg/kg yields safe and target range in neonates. An extended dosing interval of 48-hour (5 mg/kg gentamicin), was compared with twice-daily dose of 2.5 mg/kg gentamicin. Infants in the 48-hour interval and in the twice-daily achieved peak gentamicin concentrations of 9.43 µg/ml and 6.0 µg/ml, respectively, (p<0.001), and trough gentamicin concentrations were 1.08 µg/ml and 1.54 µg/ml, respectively, (p<0.001). The infants born small for gestational age have a reduced gentamicin clearance, and a more prolonged gentamicin half-life than infants born appropriate for gestational age. Patent ductus arteriosus, extracorporeal membrane oxygenation, therapeutic hypothermia, and asphyxia reduce the gentamicin clearance.

Item Type: Article
Subjects: WA Public Health
WS Pediatrics
Divisions: Journals > International J Pediatrics
Depositing User: IJP IJP
Date Deposited: 24 Sep 2017 12:51
Last Modified: 24 Sep 2017 12:51
URI: http://eprints.mums.ac.ir/id/eprint/3174

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