High Gentamicin Trough Concentrations in Neonates of Less than 28 Weeks Gestational Age

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Abstract
Newborns (77) 25.5-43 wk gestational age (GA) receiving gentamicin [an antibiotic], were studied prospectively over 4 mo. Peak and trough serum concentrations were obtained on days 1, 3 and 5 of therapy. Gentamicin, 2.5 mg/kg, was given at intervals according to GA. Sixty-three of newborns of < 28 wk on doses of gentamicin of 2.5 mg/kg every 24 h (q24h), 75% of < 28 wk on gentamicin q18h, 90% of newborns of 23-34 wk (on q18h) and 82% of those of > 34 wk GA on q12h had serum gentamicin trough concentrations .ltoreq. 2.0 .mu.g/ml on day 1. By day 3, 5/5 newborns of < 28 wk (q18h) had trough concentrations > 2.0 .mu.g/ml, whereas only 20% of those on the q24h regimen had high trough concentrations (P < 0.05). Possible risk factors associated with altered gentamicin disposition in neonates are discussed.

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