Abstract
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.
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Abbreviations
- MIC:
-
minimal inhibitory concentration
- EMIT:
-
enzyme immunologic method
References
Abramovich SJ, Gregory S, Slemick M, Stewart A (1979) Hearing loss in very low birthweight infants treated with neonatal intensive care. Arch Dis Child 54:421–426
Arbeter AM, Saccar CL, Eisner S, Sarni E, Yaffe SJ (1983) Tobramycin sulfate elimination in premature infants. J Pediatr 103:131–135
Assael BM, Gianni V, Marini A, Peneff P, Sereni F (1977) Gentamicin dosage in preterm and term neonates. Arch Dis Child 52:883–886
Buckwald S, Zorn WA, Egan EA (1984) Mortality and follow-up data for neonates weighing 500 to 800 grams at birth. AJDC 138:779–782
Elinder G, Aperia A (1983) Development of glomerular filtration rate and excretion of beta-2-microglobulin in neonates during gentamicin treatment. Acta Paediatr Scand 72:219–224
Feldman H, Guignard J-P (1982) Plasma creatinine in the first month of life. Arch Dis Child 57:123–126
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 63:443–450
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 1–30
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 399–416
Kahlmeter G (1980) Netilmicin, Clinical pharmacokinetics and aspects on dosage schedules. An overview. Scand J Infect Dis [Suppl] 23:74–81
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 124:224–231
McCracken Jr GH, Chrane DF, Thomas ML (1971) Pharmacologic evaluation of gentamicin in newborn infants. J Infect Dis 124:214–223
McCracken Jr GH, Nelson JD (1977) Antimicrobial therapy for newborns. Grune and Stratton, New York
Neu HC (1981) Current practices in antimicrobial dosing. Rev Infect Dis 3:12–18
Neu HC (1983) Condiderations about the relationship of inhibitory concentrations and the pharmacologic and toxic properties of antimicrobial agents. Diagn microbiol infect dis 1:41–47
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 19:508–512
World Health Organization (1977) Manual of international statistical classifications of diseases. Vol. 1: Injuries and causes of death. World Health Organization, Geneva, p 763
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Dahl, L.B., Melby, K., Gutteberg, T.J. et al. Serum levels of ampicillin and gentamycin in neonates of varying gestational age. Eur J Pediatr 145, 218–221 (1986). https://doi.org/10.1007/BF00446070
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DOI: https://doi.org/10.1007/BF00446070