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Aim: To evaluate an extended interval dosing (EID) regimen of gentamicin in neonates ≤ 28 weeks gestation. Methods: In 2008, an EID regimen for gentamicin was introduced for all neonates admitted to the NICU in Calgary. The dosing interval was based on a 22 h level after the first dose of 5mg/kg. We conducted an observational study in 33 infants ≤ 28 weeks gestation on the EID regimen from the first day of life and compared gentamicin peak and trough levels with a historical control of 34 infants who received gentamicin in a dose of 2.5 mg/kg every 24 h (TID, traditional interval dosing). Results: In the EID group, based on the 22 h level, dosing interval was 36 hours in 20 and 48 hours in 13 neonates. All neonates, except one, achieved therapeutic peak and trough levels. Compared to the TID group, the EID group had higher peak levels (median 9.8 μg/ml vs. 4.6 μg/ml, p < 0.001) with no difference in trough levels. With target peak levels of 5-12 μg/ml and trough levels of < 2 μg/ml, a higher proportion of neonates in the TID group would need dose adjustment. Conclusion: In neonates ≤ 28 weeks gestation, an EID regimen from day one of life, using a single level 22 h after the first dose for dosing interval, achieves therapeutic peak and trough levels and more optimum peak levels as compared to a TID regimen. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.
Division of Neonatology, Department of Pediatrics, Faculty of Medicine, University of Calgary, Alberta, Canada Department of Pharmacy, Alberta Health Services, Calgary, Alberta, Canada Staff Neonatologist, Victoria General Hospital, Victoria, BC, Canada.
This article was published in the following journal.
Name: Acta paediatrica (Oslo, Norway : 1992)
Current gentamicin dosing algorithms in adult populations target a high peak concentration (Cmax) assuring efficacy and a drug-free period (concentration
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