Extended interval dosing of gentamicin in premature neonates ≤ 28-week gestation
Article first published online: 7 SEP 2012
© 2012 The Author(s)/Acta Pædiatrica © 2012 Foundation Acta Pædiatrica
Volume 101, Issue 11, pages 1134–1139, November 2012
How to Cite
Alshaikh, B., Dersch-Mills, D., Taylor, R., Akierman, A. R. and Yusuf, K. (2012), Extended interval dosing of gentamicin in premature neonates ≤ 28-week gestation. Acta Paediatrica, 101: 1134–1139. doi: 10.1111/j.1651-2227.2012.02820.x
- Issue published online: 1 OCT 2012
- Article first published online: 7 SEP 2012
- Accepted manuscript online: 17 AUG 2012 02:15AM EST
- Received 10 April 2012; revised 20 July 2012; accepted 8 August 2012.
- Extended interval;
- Peak levels;
- Trough levels
Aim: To evaluate an extended interval dosing (EID) regimen of gentamicin in neonates ≤28-week gestation.
Methods: In 2008, an EID regimen for gentamicin was introduced for all neonates admitted to the NICU in Calgary. The dosing interval was based on a 22 h level after the first dose of 5mg/kg. We conducted an observational study in 33 infants ≤28-week gestation on the EID regimen from the first day of life and compared gentamicin peak and trough levels with a historical control of 34 infants who received gentamicin in a dose of 2.5 mg/kg every 24 h (TID, traditional interval dosing).
Results: In the EID group, based on the 22 h level, dosing interval was 36 h in 20 neonates and 48 h in 13 neonates. All neonates, except one, achieved therapeutic peak and trough levels. Compared to the TID group, the EID group had higher peak levels (median 9.8 μg/mL vs. 4.6 μg/mL, p < 0.001) with no difference in trough levels. With target peak levels of 5–12 μg/mL and trough levels of <2 μg/mL, a higher proportion of neonates in the TID group would need dose adjustment.
Conclusion: In neonates ≤ 28-week gestation, an EID regimen from day one of life, using a single level 22 h after the first dose for dosing interval, achieves therapeutic peak and trough levels and more optimum peak levels as compared to a TID regimen.