Assessment of bioelectrical impedance for individualising gentamicin therapy in neonates

Sidhu, J.S., Charles, B.G., Triggs, E.J., Tudehope, D.I., Gray, P.H. and Steer, P.A. (1993) Assessment of bioelectrical impedance for individualising gentamicin therapy in neonates. European Journal of Clinical Pharmacology, 44 3: 253-258.


Author Sidhu, J.S.
Charles, B.G.
Triggs, E.J.
Tudehope, D.I.
Gray, P.H.
Steer, P.A.
Title Assessment of bioelectrical impedance for individualising gentamicin therapy in neonates
Journal name European Journal of Clinical Pharmacology
Publication date 1993-03
Sub-type Article
DOI 10.1007/BF00271367
Volume number 44
Issue number 3
ISSN 0031-6970;1432-1041
Start page 253
End page 258
Total pages 6
Place of publication Heidelberg, Germany
Publisher Springer
Language eng
Formatted abstract The use of bioelectrical impedance (BI) analysis as a non-invasive approach for individualising gentamicin therapy in newborn infants has been investigated in a two phase study. In Phase I, 1/impedance and length2 were identified as statistically significant predictors of the distribution volume of gentamicin (Adj R2 = 0.78, CV = 12.42%), and length2/impedance and post-conceptual age were predictors of total systemic clearance (Adj R2 = 0.83, CV = 14.5%), following the administration of 2.5 mg · kg-1 gentamicin to 17 neonates (gestational age (GA) 27 to 36 weeks). In a prospective validation of these relationships in an independent (Phase II) group of 27 infants (Ga 26 to 41 weeks), predicted serum gentamicin concentrations were clsoe to those achieved. Several instances of high prediction errors (predicted minus achieved levels) were observed in infants with known or suspected renal impairment and they caused significant (P < 0.05) perturbation in the bias and accuracy of the models. Daily BI measures over a four to five day period were able to detect individual changes in the fat-free body compartments, which were translated into alterations in gentamicin regimens. This simple, non-invasive and relatively inexpensive bedside technique provides a potentially valuable means to individualise gentamicin therapy without relying on the measurement of serum gentamicin concentration.
Keyword Bioelectrical impedance
Gentamicin
Neonates
Non-invasive technique
Pharmacokinetics
Plasma levels
Predictive models
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article
Collection: School of Pharmacy Publications
 
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