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Gentamicin interval in newborn infants as determined by renal function and postconceptional age

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Abstract

We evaluated the relationship between gentamicin pharmacokinetics and glomerular filtration rate in newborn infants to estimate the appropriate interval of administration in neonates with renal insufficiency. Gentamicin half-life (Gt 1/2) could be predicted from plasma creatinine concentration (Pcr) (r=0.78); the prediction was minimally but significantly increased (r=0.81) by adding postconceptional age to a multiple regression analysis. Infants with a postconceptional age of 29 weeks or more and a Pcr of 1 mg/dl or more had significantly greater trough and peak gentamicin levels than those with a Pcr less than 1 mg/dl. If gentamicin is indicated in a patient with renal insufficiency, the interval of administration should be 2–3 Gt 1/2, which can be estimated from Pcr (Gt 1/2=2.0+7.7 Pcr). The interval can then be adjusted according to peak and trough gentamicin levels.

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References

  1. Zarowitz BJM, Wynn RJ, Clarke DF, Buckwald S, Szefler SJ (1982) High gentamicin trough concentrations in neonates of less than 28 weeks of gestational age. Dev Pharmacol Ther 5: 68–75

    PubMed  Google Scholar 

  2. Sirinavin S, McCracken GH, Nelson JG (1980) Determining gentamicin dosage in infants and children in renal failure. J Pediatr 96: 331–334

    PubMed  Google Scholar 

  3. Ksaik JW, Jenkins S, Leuschen MP, Nelson RM (1985) Postconceptional age and gentamicin half-life. J Pediatr 106: 502–505

    PubMed  Google Scholar 

  4. Reimche LD, Rooney ME, Hindmarsh KW, Sankaran K (1987) An evaluation of gentamicin dosing according to renal function in neonates with suspected spesis. Am J Perinatol 4: 262–265

    PubMed  Google Scholar 

  5. Szefler SJ, Wynn RJ, Clarke DF (1980) Relationship of gentamicin serum concentrations to gestational age in preterm and term neonates. J Pediatr 97: 312–315

    PubMed  Google Scholar 

  6. Charlton CK, Needelman H, Thomas RW, Kortas K (1986) Gentamicin dosage recommendations for neonates based on half-life predictions from birthweight. Am J Perinatol 3: 28–32

    PubMed  Google Scholar 

  7. Kildoo C, Modanlou HD, Komatsu G, Harralson A, Hodding J (1984) Developmental pattern of gentamicin kinetics in very low birth weight (VLBW) sick infants. Dev Pharmacol Ther 7: 345–356

    PubMed  Google Scholar 

  8. Lugo EJ, Smith FR, Rawlings JS, Bass JW (1986) Optimal gentamicin therapy in premature neonates: a dosage regimen adjusted for gestational age. J perinatol 6: 337–341

    Google Scholar 

  9. Roberts RJ (1984) Drug therapy in infants. Pharmacologic principles and clinical experience. Saunders, Philadelphia, pp 61–70

    Google Scholar 

  10. Hindmarsh KW, Nation RL, Williams GL, French JN (1983) Pharmacokinetics of gentamicin in very low birth weight preterm infants. Eur J Clin Pharmacol 24: 649–653

    PubMed  Google Scholar 

  11. Zager RA, Sharma HM, Johannes GA (1983) Gentamicin increases renal susceptibility to an acute ischemic insult. J Lab Clin Med 101 670–678

    PubMed  Google Scholar 

  12. Spiegel DM, Shanley PF, Molitoris BA (1990) Mild ischemia predisposes the S3 segment to gentamicin toxicity. Kidney Int 38: 459–464

    PubMed  Google Scholar 

  13. McCracken GH, West NR, Horton LJ (1971) Urinary excretion of gentamicin in the neonatal period. J Infect Dis 123: 257–262

    PubMed  Google Scholar 

  14. McCracken GH, Chrane DF, Thomas ML (1971) Pharmacologic evaluation of gentamicin in newborn infants. J Infect Dis 124: S214-S223

    Google Scholar 

  15. Riviere JE (1982) Limitations on the physiologic interpretation of aminoglycoside body clearance derived from pharmacokinetic studies. Res Commun Chem Pathol Pharmacol 38: 31–42

    PubMed  Google Scholar 

  16. Koren G, James A, Perlman M (1985) A simple method for the estimation of glomerular filtration rate by gentamicin pharmacokinetics during routine monitoring in the newborn. Clin Pharmacol Ther 38: 680–685

    PubMed  Google Scholar 

  17. Keyes PS, Johnson CK, Rawlins T (1989) Predictors of trough serum gentamicin concentrations in neonates. Am J Dis Child 143: 1419–1423

    PubMed  Google Scholar 

  18. Phaneuf D, Franke E, Neu HC (1980) Rapid, reproducible immunoassay for gentamicin. J Clin Microbiol 11: 266–269

    PubMed  Google Scholar 

  19. Benet LZ, Sheiner LB, Sande MA, Mandell GL (1985) In: Goodman LS, Gilman AG (eds) The pharmacological basis of therapeutics. MacMillan, New York, pp 3–34 and 1150–1169

    Google Scholar 

  20. Clermont MJ, Brion L, Schwartz GJ (1986) Reliability of plasma creatinine measurement in children. Clin Pediatr (Phila) 25: 569–572

    Google Scholar 

  21. Schwartz GJ, Feld LG, Langford DJ (1984) A simple estimate of glomerular filtration rate in full term infants during the first year of life. J Pediatr 104: 849–854

    PubMed  Google Scholar 

  22. Brion L, Fleischman AR, McCarton C, Schwartz GJ (1986) A simple estimate of glomerular filtration rate in low birth weight infants during the first year of life: non invasive assessment of body composition and growth. J Pediatr 109: 698–707

    PubMed  Google Scholar 

  23. Brion L, Fleischman AR, Schwartz GJ (1985) Evaluation of four length-weight formulas for estimating body surface area in newborn infants. J Pediatr 107: 801–803

    PubMed  Google Scholar 

  24. Brion LP (1990) Use of a Lotus 1-2-3 spreadsheet to plot the confidence and the prediction intervals in linear regression analysis. Comput Biol Med 20: 129–134

    PubMed  Google Scholar 

  25. Miranda JC, Schimmel MM, James LS, Spinelli W, Rosen TS (1985) Gentamicin kinetics in the neonate. Pediatr Pharmacol 5: 57–61

    Google Scholar 

  26. Riff L, Schauff V (1982) Use of aminoglycosides in the neonate. Semin Perinatol 6: 155–165

    PubMed  Google Scholar 

  27. Edgren B, Karna P, Sciamanna D, Dolanski E (1984) Gentamicin dosing in the newborn. Use of a one-compartment open pharmacokinetic model to individualize dozing. Dev Pharmacol Ther 7: 263–272

    PubMed  Google Scholar 

  28. Landers S, Berry PL, Kearns GL, Kaplan SL, Rudolph AJ (1984) Gentamicin disposition and effect on development in the very low birth weight infant. Dev Pharmacol Ther 7: 285–302

    PubMed  Google Scholar 

  29. Schwartz GJ, Brion L, Spitzer A (1987) The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children and adolescents. Pediatr Clin North Am 34: 579–590

    Google Scholar 

  30. Bryan CB, John JF, Pai MS, Austin TL (1985) Gentamicin vs cefotaxime for therapy of neonatal sepsis. Relationship to drug resistance. Am J Dis Child 139: 1086–1089

    PubMed  Google Scholar 

  31. Leff RD, Andersen RD, Roberts RJ (1984) Simplified gentamicin dosing in neonates: a time-and cost-efficient approach. Pediatr Infect Dis J 3: 208–212

    Google Scholar 

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Albert Einstein College of Medicine and Montefiere Medical Center, Room 8S7, Pelham parkway South and Eastchester Road, 10461, Bronx, New York, USA

    Luc P. Brion & Alan R. Fleischman

  2. Division of Nephrology, Department of Pediatrics, Albert Einstein College of Medicine and Montefiere Medical Center, Room 8S7, Pelham parkway South and Eastchester Road, 10461, Bronx, New York, USA

    George J. Schwartz

Authors
  1. Luc P. Brion
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  2. Alan R. Fleischman
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  3. George J. Schwartz
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Brion, L.P., Fleischman, A.R. & Schwartz, G.J. Gentamicin interval in newborn infants as determined by renal function and postconceptional age. Pediatr Nephrol 5, 675–679 (1991). https://doi.org/10.1007/BF00857868

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  • DOI: https://doi.org/10.1007/BF00857868

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