European Journal of Pediatrics

, Volume 145, Issue 3, pp 218–221 | Cite as

Serum levels of ampicillin and gentamycin in neonates of varying gestational age

  • L. B. Dahl
  • K. Melby
  • T. J. Gutteberg
  • G. Størvold
Short Communications


Serum concentrations of gentamycin and ampicillin were investigated at loading and in steady state in two groups of neonates, of 26–33 weeks and 34–40 weeks gestation. At loading the usual intravenous dose of gentamycin (2.5 mg/kg) was increased by 50%, the usual intravenous dose of ampicillin (50 mg/kg) by 100%. Gentamycin and ampicillin were administered subsequently at the same intervals, 12 h in the 34–40 weeks group, and 18 h in the 26–33 weeks group. Adequate serum levels were achieved from the first day of treatment. For practical reasons ampicillin and gentamycin can be administered subsequently at identical intervals also when the intervals exceed 12 h. The ideal dosing interval for gentamycin in very preterm neonates is 24 h. When treating small preterm and term neonates with an aminoglycoside, rapid serum concentration analyses should be available, and the treatment modified accordingly.

Key words

Neonates Gentamycin Ampicillin Loading dose Dosing intervals 



minimal inhibitory concentration


enzyme immunologic method


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  1. 1.
    Abramovich SJ, Gregory S, Slemick M, Stewart A (1979) Hearing loss in very low birthweight infants treated with neonatal intensive care. Arch Dis Child 54:421–426Google Scholar
  2. 2.
    Arbeter AM, Saccar CL, Eisner S, Sarni E, Yaffe SJ (1983) Tobramycin sulfate elimination in premature infants. J Pediatr 103:131–135Google Scholar
  3. 3.
    Assael BM, Gianni V, Marini A, Peneff P, Sereni F (1977) Gentamicin dosage in preterm and term neonates. Arch Dis Child 52:883–886Google Scholar
  4. 4.
    Buckwald S, Zorn WA, Egan EA (1984) Mortality and follow-up data for neonates weighing 500 to 800 grams at birth. AJDC 138:779–782Google Scholar
  5. 5.
    Elinder G, Aperia A (1983) Development of glomerular filtration rate and excretion of beta-2-microglobulin in neonates during gentamicin treatment. Acta Paediatr Scand 72:219–224Google Scholar
  6. 6.
    Feldman H, Guignard J-P (1982) Plasma creatinine in the first month of life. Arch Dis Child 57:123–126Google Scholar
  7. 7.
    Finitzo-Hieber T, McCracken Jr GH, Roeser RJ, Allen DA, Chrane DF, Morrow J (1979) Ototoxicity in neonates treated with gentamicin and kanamycin: Results of a four-year controlled followup study. Pediatrics 63:443–450Google Scholar
  8. 8.
    Finn AL, Taylor WJ, Kane WJ (1981) General principles. Practical applications of serum concentration monitoring. In: Taylor WJ, Finn AL (eds) Individualizing drug therapy, Vol 1. Gross, Townsend, Frank, New York, pp 1–30Google Scholar
  9. 9.
    Glasgow LA, Overall Jr JC (1983) Infections of the newborn. In: Nelson WE, Vaughan III VC, Behrman RE (eds) Textbook of pediatrics. (12th edn) WB Saunders Co. Philadelphia, pp 399–416Google Scholar
  10. 10.
    Kahlmeter G (1980) Netilmicin, Clinical pharmacokinetics and aspects on dosage schedules. An overview. Scand J Infect Dis [Suppl] 23:74–81Google Scholar
  11. 11.
    Klein JO, Herschel M, Therakan RM, Ingall D (1971) Gentamicin in serious neonatal infections: Absorption, excretion and clinical results in 25 cases. J Infect Dis 124:224–231Google Scholar
  12. 12.
    McCracken Jr GH, Chrane DF, Thomas ML (1971) Pharmacologic evaluation of gentamicin in newborn infants. J Infect Dis 124:214–223Google Scholar
  13. 13.
    McCracken Jr GH, Nelson JD (1977) Antimicrobial therapy for newborns. Grune and Stratton, New YorkGoogle Scholar
  14. 14.
    Neu HC (1981) Current practices in antimicrobial dosing. Rev Infect Dis 3:12–18Google Scholar
  15. 15.
    Neu HC (1983) Condiderations about the relationship of inhibitory concentrations and the pharmacologic and toxic properties of antimicrobial agents. Diagn microbiol infect dis 1:41–47Google Scholar
  16. 16.
    Ratcliff RM, Mirelli C, Moran E, O'Leary D, White R (1981) Comparison of five methods for the assay of serum gentamicin. Antimicrob Agents Chemother 19:508–512Google Scholar
  17. 17.
    World Health Organization (1977) Manual of international statistical classifications of diseases. Vol. 1: Injuries and causes of death. World Health Organization, Geneva, p 763Google Scholar

Copyright information

© Springer-Verlag 1986

Authors and Affiliations

  • L. B. Dahl
    • 1
  • K. Melby
    • 2
  • T. J. Gutteberg
    • 1
  • G. Størvold
    • 2
  1. 1.Department of PaediatricsUniversity HospitalTromsøNorway
  2. 2.Department of MicrobiologyUniversity HospitalTromsøNorway

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