An Evaluation of a Gentamicin Dosing Protocol in the Treatment of Bacterial Infections in Neonates

Abstract

Objective: To determine the safety and efficacy of a revised gentamicin dosing regimen. Study Design: Retrospective study of neonates ≤ 1 month corrected gestational age and admitted to one of 3 Neonatal Units between June 1and December 31, 2012. The primary outcome was trough levels ≤2 mg/L. Result: 151 neonates (mean 33.5 weeks) were included. 80% of patients had a trough level ≤2 mg/L while 94% had peak levels of 5-10 mg/L. The majority of trough levels >2 mg/L were in infants 29-36 weeks corrected and ≤14 days and in term babies ≤7 days of age. Lower gestational age and lower 1 and 5 minute Apgar scores were associated with a high trough. Conclusion: Our gentamicin dosing regimen is suboptimal for moderately preterm neonates who are ≤14 days and term infants ≤7 days. Further research is needed to determine the most effective gentamicin dosing regimen, particularly in preterm neonates.