Gentamicin: Pharmacologic Observations in Newborns and Infants

“…Nunnery and Riley (1969) observed a mean peak serum gentamicin level of 1I88 jig/ml on the third day of treatment 30 minutes after the injection of 0*4 mg/kg gentamicin every 8 hours. On the basis of in vitro sensitivity tests this dosage regimen would be expected to be frequently ineffective.…”

Section: Resultsmentioning

confidence: 93%

“…A serum gentamicin level of less than 1 ,ug/ml was arbitrarily defined as inadequate on the basis of in vitro sensitivity tests (Barber and Waterworth, 1966;Nunnery and Riley, 1969;McCracken and Jones, 1970). The realization that nearly 20% of the infants had inadequate serum gentamicin levels 1 hour after the first dose and half had levels less than 1 ,ug/ml just before the second dose, led to reappraisal of the initial dose.…”

Section: Resultsmentioning

confidence: 99%

Clinical Pharmacology of Gentamicin in the Newborn Infant

Milner¹,

Ross²,

Froud³

et al. 1972

Archives of Disease in Childhood

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. (1972). Archives of Disease in Childhood, 47, 927. Clinical pharmacology of gentamicin in the newborn infant. Newborn infants with suspected bacterial infection were treated with intramuscular gentamicin. Serum levels of the drug were measured 1 hour after the first dose, immediately before the second dose, and immediately before and 1 hour after a dose given on the third day.On a low dosage regimen (1 mg/kg every 8 hours) 9 of 17 infants had serum gentamicin levels below the required minimum level of 1 ,ug/ml immediately before the second dose, and 5 of 19 infants had similarly low levels on the third day. On a high dosage regimen (3 mg/kg initially, then 2 mg/kg every 8 hours) 2 of 10 infants had preinjection serum gentamicin levels below 1 ,ig/ml on the first day, and 3 out of 16 had similar levels on the third day. The mean ( + SE) serum gentamicin level on the high dosage regimen was 5 0 0 ±05 jg/ml 1 hour after the first injection, 1 9±0 4 Fg/ml just before the second injection, and on the third day 1 9 ±03 ,ug/ml just before an injection and 5 1 ±0 * 5 [Lg/ml 1 hour after injection. The highest serum gentamicin level recorded in any of the 40 infants studied was 8 2 ,ug/ml.On the first day of treatment with the low dose regimen, a mean of 21 % (range 9-68%) of the injected dose was recovered from the urine; and on the third or fourth day a mean of 44% (range 17-76%) of the gentamicin injected on that day was recovered.In 4 infants who died tissue gentamicin levels were measured in the liver, lungs, heart, kidneys, and brain, the highest concentration being in the kidney with low levels in the heart, liver, and brain, while levels in the lungs were intermediate. Neonatal renal and pulmonary infections are thus likely to be suitably treated with gentamicin.Bacteriological studies confirmed the effectiveness of gentamicin in the treatment of neonatal infection, but a dosage regimen derived by extrapolation from older children frequently resulted in inadequate serum levels, and a higher dosage regimen giving more satisfactory results was therefore defined.The effectiveness of gentamicin in vitro against Pseudomonas pyocyanea and other bacterial species commonly found in hospital nurseries (Barber and Waterworth, 1966)

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“…Satisfactory concentrations of gentamiein were found in the cerebrospinal fluid of a patient with meningitis. 19 Gentamicin was weIl tolerated when administered intravenously. There were no special problems associated with this route of administration.…”

Section: Discussionmentioning

confidence: 99%

Gentamicin sulfate distribution in body fluids

Rodriguez

Stewart

Bodey

1970

Clin Pharma and Therapeutics

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Pharmacological studies were conducted on patients receiving gentamicin sulfate intravenously. The mean peak serum level was 4.5 P,g per milliliter after the administration of 40 mg. per square meter gentamicin sulfate. The serum half‐life was approximately 2 hours and the decrease was exponential. There was no evidence of drug accumulation when administered at a dose of 30 mg. per square meter every 6 hours over a 10 day period. The concentration of gentamicin in thoracic duct lymph paralleled the simultaneous serum concentration. The drug did not diffuse readily into the cerebrospinal fluid. The intravenous administration of gentamicin was well tolerated and no unexpected toxicity was observed.

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Gentamicin: Pharmacologic Observations in Newborns and Infants

Cited by 21 publications

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Should clearance be normalised to body surface or to lean body mass?

Should clearance be normalised to body surface or to lean body mass?

Clinical Pharmacology of Gentamicin in the Newborn Infant

Gentamicin sulfate distribution in body fluids

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