Monitoring serum levels of gentamicin in neonates.

M J Rocha, A M Almeida, E Afonso, V Martins, F Leitão, J Santos, A C Falcão


Newborn infants in intensive care units demonstrated a higher incidence of gestational age below 31 week. Obstetrical and neonatal diseases procedures required for the management of critically ill neonates are associated with an increased risk of infections. Gentamicin is an aminoglycoside antibiotic often used to treat gram-negative bacillary infections and suspected sepsis in neonates. The risk of toxicity or poor efficacy is further increased due to the recognised wide intra and interpatient variability of the newborn. The present work involved 49 infants of 31.3 +/- 4.1 (mean +/- SD) weeks of gestational age, weighing 1.7 +/- 0.8 kg and were treated with standard doses of gentamicin (3.8 +/- 0.9 mg/kg/day). Routine clinical care data were retrospectively collected from the medical records in the neonatal intensive-care unit at Coimbra University Hospital. Data analysis demonstrated that potentially toxic serum levels were observed in 49% of newborn infants (trough > 2 mg/L). Additionally, the obtained results also showed that 7.5% of peak concentrations were found to be higher than 10 mg/L. Potentially sub-therapeutic concentrations were observed in 15% of the patients (peak > 6 mg/L).

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