The evaluation of the appropriate gentamicin use for preterm infants

  • Daisuke Shimizu
  • Shun Ichikawa
  • Takayuki HoshinaEmail author
  • Mayumi Kawase
  • Kentaro Tanaka
  • Shunsuke Araki
  • Tadamune Kinjo
  • Koichi Kusuhara
Original Article


Gentamicin (GM) is used for neonates as the initial treatment for neonatal bacterial infection. An association between high trough GM levels and the elevation of the serum creatinine (sCr) level and hearing loss has been reported, although there have been no reports investigating the serial changes in the sCr level in preterm neonates treated with GM. The present study evaluated the serial changes in the sCr level and the incidence of hearing loss in preterm neonates treated with GM. This study included 56 neonates born at a gestational age of 32–36 weeks. Fifteen (group 1) and 20 (group 2) neonates were treated with 2.5 mg/kg of GM every 12 h and 4 mg/kg of GM every 36 h, respectively. Group 3 included 21 neonates without GM therapy. Serum GM levels, serial changes in the sCr levels, and the incidence of hearing loss were then compared among the three groups. The serum trough GM level in group 2 was significantly lower than that in group 1 (P < 0.001), whereas the serum peak GM levels in these groups were almost the same. The ratio of the sCr level at birth to that at the 5th day of life in group 1 was the lowest among the 3 groups. No neonates had hearing loss. GM therapy worsened the sCr level in late preterm neonates, especially those with multiple doses per day. The appropriate use of GM is needed in order to prevent the occurrence of nephrotoxicity.


Gentamicin Preterm infant Nephrotoxicity Ototoxicity 



We appreciate the help of Dr. Brian Quinn (Japan Medical Communication, Fukuoka, Japan) for editing the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Our prospective observational study was approved by the Institutional Review Board of University of Occupational and Environmental Health, Japan.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Daisuke Shimizu
    • 1
    • 2
  • Shun Ichikawa
    • 1
    • 2
  • Takayuki Hoshina
    • 1
    Email author
  • Mayumi Kawase
    • 1
  • Kentaro Tanaka
    • 1
    • 2
  • Shunsuke Araki
    • 1
    • 2
  • Tadamune Kinjo
    • 2
    • 3
  • Koichi Kusuhara
    • 1
    • 2
  1. 1.Department of Pediatrics, School of MedicineUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
  2. 2.Center of Maternal, Fetal and Neonatal MedicineHospital of University of Occupational and Environmental Health, JapanKitakyushuJapan
  3. 3.Department of NeonatologyFukuoka Children’s HospitalFukuokaJapan

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