Eight years' experience of an extended-interval dosing protocol for gentamicin in neonates

Background Dosing of gentamicin in neonates in Christchurch has been carried out since 2000 using a locally developed extended-interval dosing protocol. All dosing data have been recorded in a database. Aims The aims of this study were to analyse the database to determine what percentage of neonates...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2009-05, Vol.63 (5), p.1043-1049
Main Authors: Begg, Evan J., Vella-Brincat, Jane W. A., Robertshawe, Barbara, McMurtrie, Mark J., Kirkpatrick, Carl M. J., Darlow, Brian
Format: Article
Language:English
Subjects:
aminoglycosides
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - pharmacokinetics
Anti-Bacterial Agents - therapeutic use
Antibiotics
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacterial Infections - drug therapy
Biological and medical sciences
Drug dosages
Gentamicins - administration & dosage
Gentamicins - pharmacokinetics
Gentamicins - therapeutic use
Half-Life
Humans
Infant, Newborn
Kinetics
Medical sciences
Metabolic Clearance Rate
Models, Theoretical
Neonatal care
pharmacokinetics
Pharmacology
Pharmacology. Drug treatments
Plasma - chemistry
therapeutic drug monitoring
Tissue Distribution
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Summary:Background Dosing of gentamicin in neonates in Christchurch has been carried out since 2000 using a locally developed extended-interval dosing protocol. All dosing data have been recorded in a database. Aims The aims of this study were to analyse the database to determine what percentage of neonates achieved target values for Cmax, Cmin and AUC, and to use the pharmacokinetic values of gentamicin to simulate new dosing protocols. Methods Cmax, Cmin and AUC were compared with target values. Clearance (CL), volume of distribution (V) and half-life (t1/2) were estimated, and used to produce new predictive dosing protocols that were tested and compared with the results of the original protocol. Results Gentamicin concentrations from 1461 individual doses were recorded in the database. Four hundred and eight were excluded. Of the remaining 1053, 84% achieved the target Cmax (>10 mg/L), 77% the target Cmin (
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkp073