Pharmacy World and Science

, Volume 26, Issue 4, pp 242–244 | Cite as

Gentamicin usage in newborns — a simple and practical regime

  • Monika BajajEmail author
  • Katherine Palmer


Method: A prospective audit of 50 sets of gentamicin levels on the Old Gentamicin Regime was conducted. Desired levels were a trough < 2 μg/ml and peak between 5–10 μg/ml.These were taken just before and one hour after the third dose respectively. Peak levels were found to be in the sub-therapeutic range in the majority on this regime. Therefore the New Gentamicin Regime was put into practise. A re-audit was conducted of the new gentamicin regime and 60 trough levels were taken. Peak levels were taken in only 20 newborns with the intention of not doing peak levels routinely if these were satisfactory and the data were analysed.

Results: Although trough levels were satisfactory in 98% (49/50), peak levels were sub-therapeutic in 92% (46/50) on the old gentamicin regime. Following change in practise to the new gentamicin regime trough levels were satisfactory in 96.6% (58/60). We collected 20 peak levels and these were satisfactory in 80% (16/20).

Conclusions: The new gentamicin usage guideline achieves peak levels in the therapeutic range in the majority without any added risk of toxic trough levels. Peak levels need not be done routinely in all newborns on the new regime.

This study was presented as an oral communication, in the National Neonatology Conference at Warwick, England on 4 June 2003.

Dosage Gentamicin Guideline development Guidelines Neonate 


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  1. 1.
    Gooding N, Jones E, Shenoy M. Gentamicin dosing in neonatal patients. Pharm World Sci 2001; 23: 179–80.Google Scholar
  2. 2.
    RCPCH. Medicines for children. London: RCPCH Publications Limited, 1999: 245.Google Scholar
  3. 3.
    Ohler KH, Menke JA, Fuller L. Use of higher dose extended interval aminoglycosides in a neonatal intensive care unit. Am J Perinatol 2000; 17: 285–90.Google Scholar
  4. 4.
    Thureen PJ, Reiter PD, Gresores A et al. Once-versus twice-daily gentamicin dosing in neonates ≥ 34 weeks gestation: cost effective analyses. Pediatrics 1999; 103: 594–8.Google Scholar
  5. 5.
    Hayani KC, Hatzopoulos FK et al. Pharmacokinetics of once-daily dosing of gentamicin in neonates. J Pediatr 1997; 131: 76–80.Google Scholar
  6. 6.
    Daikos GL, Jackson GG, Lolans VT, Livermore DM. Adaptive resistance to aminoglycoside antibiotics from first exposure down regulation. J Infect Dis 1990; 162: 414–20.Google Scholar
  7. 7.
    Agarwal G, Rastogi A, Pyati S et al. Comparison of once daily versus twice daily gentamicin dosing regimens in infants ≥ 2500 g. J Perinatol 2002; 22: 68–74.Google Scholar
  8. 8.
    Langlass TM, Mickle TR. Standard gentamicin dosage regimen in neonates. Am J Health Syst Pharm 1999; 56: 440–3.Google Scholar
  9. 9.
    Rastogi A, Agarwal G, Pyati S, Pildes RS. Comparison of two gentamicin dosing schedules in very low birth weight infants. Pediatr Infect Dis J 2002; 21: 234–40.Google Scholar
  10. 10.
    Young TE, Magnum OB. Neofax, a manual of drugs used in neonatal care. 11th edition. Raleigh, North Carolina: Acron Publishing 1999; 32–3.Google Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  1. 1.Addenbrooke’s HospitalCambridgeUK
  2. 2.North Staffordshire HospitalStoke-on-TrentUK

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