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Pharmacy World & Science

, Volume 31, Issue 3, pp 365–368 | Cite as

Netilmicin in the neonate: pharmacokinetic analysis and influence of parenteral nutrition

  • Flora Bacopoulou
  • Maria Skouroliakou
  • Sophia L. MarkantonisEmail author
Short Research Report

Abstract

Objective The aim of this study was to investigate the impact of parenteral nutrition on netilmicin pharmacokinetics in critically ill neonates during the first week of life. Method A total of 200 neonates (gestational ages 26.4–41 weeks) treated with netilmicin (4–5 mg/kg in extended dosing intervals) for postnatal sepsis in the first week of life received either fluid therapy or parenteral nutrition. Netilmicin peak and trough serum concentrations were monitored and netilmicin pharmacokinetic parameters were compared with and without parenteral nutrition. Results There were no statistically significant differences between the pharmacokinetic parameters of netilmicin (volume of distribution, elimination half-life, clearance) in critically ill neonates >32 weeks during the first week of life that received either fluid therapy or parenteral nutrition. For neonates <32 weeks this comparison was not feasible as the majority were parenterally fed. Conclusion Provision of parenteral nutrition (versus fluid therapy) in critically ill neonates >32 weeks did not significantly affect netilmicin pharmacokinetics and therefore does not require modification of recommended netilmicin dosage regimens.

Keywords

Extended dosing intervals Neonates Netilmicin Parenteral nutrition Pharmacokinetics 

Notes

Acknowledgements

We thank Ms Amalia Papadopoulou, BPharm., MSc for her help in recording patient data.

Conflicts of interest

None declared.

References

  1. 1.
    Ronchera-Oms CL, Tormo C, Ordovas JP, Abad J, Jimenez NV. Expanded gentamicin volume of distribution in critically ill adult patients receiving total parenteral nutrition. J Clin Pharm Ther. 1995;20(5):253–8. doi: 10.1111/j.1365-2710.1995.tb00659.x.PubMedCrossRefGoogle Scholar
  2. 2.
    Tormo C, Abad FJ, Ronchera-Oms CL, Parra V, Jimenez NV. Critically-ill patients receiving total parenteral nutrition show altered amikacin pharmacokinetics. Clin Nutr. 1995;14(4):254–9. doi: 10.1016/S0261-5614(95)80008-5.PubMedCrossRefGoogle Scholar
  3. 3.
    Moore RD, Smith CR, Lietman PS. The association of aminoglycoside plasma levels with mortality in patients with gram-negative bacteremia. J Infect Dis. 1984;149(3):443–8.PubMedGoogle Scholar
  4. 4.
    Skouroliakou M, Konstantinou D, Papasarantopoulos P, Matthaiou C. Computer assisted total parenteral nutrition for pre-term and sick term neonates. Pharm World Sci. 2005;27:305–10. doi: 10.1007/s11096-005-2462-x.PubMedCrossRefGoogle Scholar
  5. 5.
    Young TE, Mangum B. Antibiotics, Netilmicin. In: Neofax. A manual of drugs used in neonatal care. 19th ed. Raleigh, NC, USA: Acorn Publishing; 2006. p. 52–3. ISBN: 1-888703-19-9.Google Scholar
  6. 6.
    Syka M, Markantonis SL, Mathas C, Maggina N. A pilot study of netilmicin pharmacokinetics during continuous venovenous hemodiafiltration. J Clin Pharmacol. 2005;45:477–81. doi: 10.1177/0091270004273949.PubMedCrossRefGoogle Scholar
  7. 7.
    Ettlinger JJ, Bedford KA, Lovering AM, Speidel BD, MacGowan AP. Pharmacokinetics of once-a-day netilmicin (6 mg/kg) in neonates. J Antimicrob Chemother. 1996;38:499–505. doi: 10.1093/jac/38.3.499.PubMedCrossRefGoogle Scholar
  8. 8.
    Siegel JD, McCracken GH, Thomas ML, Threlkeld N. Pharmacokinetic properties of netilmicin in newborn infants. Antimicrob Agents Chemother. 1979;15:246–53.PubMedGoogle Scholar
  9. 9.
    Gosden PE, Bedford KA, Dixon JJ, Speidel BD, Leaf AA, Macgowan AP. Pharmacokinetics of once-a-day netilmicin (4.5 mg/kg) in neonates. J Chemother. 2001;13(3):270–6.PubMedGoogle Scholar
  10. 10.
    Klingenberg C, Smabrekke L, Lier T, Flaegstad T. Validation of a simplified netilmicin dosage regimen in infants. Scand J Infect Dis. 2004;36:474–9. doi: 10.1080/00365540410020613.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Flora Bacopoulou
    • 1
  • Maria Skouroliakou
    • 2
  • Sophia L. Markantonis
    • 1
    Email author
  1. 1.Faculty of Pharmacy, Laboratory of Biopharmaceutics and PharmacokineticsUniversity of AthensAthensGreece
  2. 2.Harokopio University, IASO Maternity HospitalAthensGreece

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