Gentamicin interval in newborn infants as determined by renal function and postconceptional age
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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.
Key wordsGentamicin Newborn Acute renal failure Pharmacokinetics Plasma creatinine Creatinine elearence glomerular filtration rate
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