A STUDY OF GENTAMICIN DOSAGE AND LEVELS IN BABIES ADMITTED TO SPECIAL CARE BABY UNIT
What is known:
«In spite of narrow therapeutic index gentamicin remains one of the most commonly used antibiotics in Newborns.
«Drug levels are useful in minimising the toxicity while monitoring the effective levels.
«Peak and trough levels are surrogate markers of efficacy and toxicity respectively1
«Once daily dose is more effective than twice daily doses2
What is yet to be settled:
«What is the ideal dose of gentamicin – 5mg/kg/day OR 4 mg/kg/day (OR even less)
«Whether peak levels help in adjustment of drug dosage
We performed this study to review the Gentamicin dose of 4mg/kg once daily by analysing drug levels and the incidence of drug errors. We also analysed whether peak levels actually influence the dose adjustment in clinical practice.
«Research design: Retrospective
«Research setting: Level 1 Special care baby unit (SCBU) at a District General Hospital in Scotland
«Criteria of selection: Term and preterm newborns who had gentamicin drug levels performed.
«Criteria for normal range of gentamicin drug level
«Peak: 5-10 mcg/ml
«Trough <2 mcg/ml
«We conclude that our current dose of 4 mg/kg/day once a day is safe when compared with the studies using 5mg/kg as demonstrated by the low incidence of high trough levels. we recommend the use of 4 mg/kg as the standard dose in newborns more than 32 weeks of gestation rather than the current recommendation of 5 mg/kg.
«We also noticed that there is little information gained by measuring peak levels in addition to trough levels.