Eight years' experience of an extended-interval dosing protocol for gentamicin in neonates

Begg, E. J., Vella-Brincat, J. W. A., Robertshawe, B., McMurtrie, M. J., Kirkpatrick, Carl M.J. and Darlow, B. (2009) Eight years' experience of an extended-interval dosing protocol for gentamicin in neonates. Journal of Antimicrobial Chemotherapy, 63 5: 1043-1049. doi:10.1093/jac/dkp073


Author Begg, E. J.
Vella-Brincat, J. W. A.
Robertshawe, B.
McMurtrie, M. J.
Kirkpatrick, Carl M.J.
Darlow, B.
Title Eight years' experience of an extended-interval dosing protocol for gentamicin in neonates
Journal name Journal of Antimicrobial Chemotherapy   Check publisher's open access policy
ISSN 0305-7453
Publication date 2009-01-01
Sub-type Article (original research)
DOI 10.1093/jac/dkp073
Open Access Status
Volume 63
Issue 5
Start page 1043
End page 1049
Total pages 7
Editor Johnson, A. P.
Place of publication United Kingdom
Publisher Oxford University Press
Language eng
Subject C1
110309 Infectious Diseases
920109 Infectious Diseases
Abstract Background: Dosing of gentamicin in neonates in Christchurch has been carried out since 2000 using a locally developed extended-interval dosing protocol. All dosing data have been recorded in a database. Aims: The aims of this study were to analyse the database to determine what percentage of neonates achieved target values for C, C and AUC, and to use the pharmacokinetic values of gentamicin to simulate new dosing protocols. Methods: C, C and AUC were compared with target values. Clearance (CL), volume of distribution (V) and half-life (t) were estimated, and used to produce new predictive dosing protocols that were tested and compared with the results of the original protocol. Results: Gentamicin concentrations from 1461 individual doses were recorded in the database. Four hundred and eight were excluded. Of the remaining 1053, 84% achieved the target C (>10 mg/L), 77% the target C (<1 mg/L) and 63% the target AUC (within 80% to 125%). The number achieving target C and C values was improved markedly by prolonging the dosing intervals, but not by altering the predictive equations. Since the majority of the neonates only received a single dose of gentamicin, a new V-based model was also tested, and performed well. CL (L/kg) increased, while V (L/kg) and t (h) both decreased with respect to weight. Conclusions: Extending the dose interval improved the success in achieving target C and C, while revision of the dosing equation did not. A V -based model provides an alternative approach to the first dose of gentamicin in neonates.
Keyword Aminoglycosides
Therapeutic Drug Monitoring
pharmacokinetics
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Pharmacy Publications
 
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Created: Fri, 05 Jun 2009, 22:11:47 EST by Charna Kovacevic on behalf of School of Pharmacy