Advertisement

Pharmacy World & Science

, Volume 29, Issue 3, pp 104–108 | Cite as

Performance of gentamicin population kinetic parameters in Portuguese neonates

  • Marília J. Rocha
  • Anabela M. Almeida
  • Amílcar C. FalcãoEmail author
  • Margarida M. Caramona
Research Article

Abstract

Aim

To evaluate the performance of eight different sets of gentamicin populational pharmacokinetic parameters, regarding potential implementation in clinical pharmacokinetic software as prior information.

Methods

The study involved 49 patients of 31.3±4.1 weeks of gestational age (GA), receiving gentamicin, and for whom peak and trough concentrations were obtained. Accuracy and precision were assessed by mean prediction error (ME), mean squared prediction error (MSE) and root mean squared prediction error (RMSE). Weighted prediction-error analysis was carried out in order to evaluate peak and trough concentrations together (MEw, MSEw and RMSEw).

Results

The analysis showed CL=0.036 l/h/kg (<34 weeks GA) or CL=0.051 l/h/kg (≥34 weeks GA), and V d =0.5 l/kg (≤37 weeks GA) or V d =0.4 l/kg (>37 weeks of GA) as the most accurate and precise set of pharmacokinetic parameters (Set 4), presenting the highest percentage of clinically acceptable estimates (ErrorPeak<1 μg/ml, and ErrorTrough <0.375 μg/ml).

Conclusion

The adoption of the previously mentioned set of parameters as population estimates seems to be the best option, bearing in mind the obtained results. However, we strongly believe that pharmacokinetic parameter determination of gentamicin should be carried out whenever possible in order to improve the rationale and cost-effectiveness of therapy.

Key words

Gentamicin Infant Newborn Pharmacokinetics Prediction error 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Weber W, Kewitz G, Rost KL, Lobby M, Nitz M and Harnisch L (1993). Population kinetics of gentamicin in neonates. Eur J Clin Pharmacol 44(Suppl. 4): S23–S25 PubMedCrossRefGoogle Scholar
  2. 2.
    Delgado RG, Romero AS, Gil RT and Macián AM (1997). Monitorizacón de niveles séricos de gentamicina en neonatos. Utilidade para el ajuste de dosis. Anales Españoles de Pediatria 46: 47–52 Google Scholar
  3. 3.
    Murphy JE, Austin ML and Frye R (1998). Evaluation of gentamicin pharmacokinetics and dosing protocols in 195 neonates. Am J Health-Syst Pharm 55: 2280–2288 PubMedGoogle Scholar
  4. 4.
    Semchuk W, Shevchuk YM, Sankaran K and Wallace SM (1995). Prospective, randomized, controlled evaluation of a gentamicin loading dose in neonates. Biol Neonate 67: 13–20 PubMedCrossRefGoogle Scholar
  5. 5.
    Kelman AW, Thomson AH, Whiting B, Bryson SM, Steedman DA and Mawer GE (1984). Estimation of gentamicin and volume of distribution in neonates and young children. B J Clin Pharmcol 18: 685–692 Google Scholar
  6. 6.
    Semchuk W, Borgmann J and Bowman L (1993). Determination of a gentamicin loading dose in neonates and infants. Ther Drug Monitor 15: 47–51 Google Scholar
  7. 7.
    Izquierdo M, Lanao JM, Cervero L, Jimenez NV and Dominguez-Gil A (1992). Population pharmacokinetics of gentamicin in premature infants. Ther Drug Monitor 14: 177–183 Google Scholar
  8. 8.
    Thomson AH, Way S, Bryson SM, McGovern EM, Kelman AW and Whiting B (1988). Population pharmacokinetics of gentamicin in neonates. Dev Pharmacol Ther 11: 173–179 PubMedGoogle Scholar
  9. 9.
    Sheiner LB and Beal SL (1981). Some suggestions for measuring predictive performance. J Pharmacokinet Biopharm 4: 503–512 CrossRefGoogle Scholar
  10. 10.
    Faura CC, Feret MA and Horga JF (1991). Monitoring serum levels of gentamicin to develop a regimen for gentamicin dosage in newborns. Ther Drug Monitor 13: 268–276 CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Marília J. Rocha
    • 1
  • Anabela M. Almeida
    • 1
  • Amílcar C. Falcão
    • 1
    Email author
  • Margarida M. Caramona
    • 1
  1. 1.Laboratory of Pharmacology, Faculty of PharmacyUniversity of CoimbraCoimbraPortugal

Personalised recommendations