Abstract
To improve gentamicin (GMS) dosage regimens in neonates, data from 46 infants requiring GMS therapy were analyzed for K2 (.693/half-time) using the model:
Dose K1 Body Volume of Distribution (Vd) K2 Excretion.
K1=1.8 hours−1 and Vd=14.7% of body weight.
K2 (hrs.−1) was calculated to fit the serum level found. The patients were 1-14 days old (mean 5.5), with a gestational age (GA) of 29-42 weeks (mean 37.9) and a serum creatinine of ≥0.5 mg/dl. A serum GMS level was drawn 3-12 hours into the dose interval.
Fourteen clinical parameters were examined by stepwise multiple regression (SBC Call-370 Statpack). Estimated creatinine clearance (CCr), computed as described earlier by this laboratory, was 6-34 ml/min./1.73 M2 (mean 17) and correlated best with K2. Other predictors, in order, were weight/length percentile (WL), GA, age (A) and sex (S, female=0. male=1). K2=.32838 + .00276CCr -.00167WL + .01792GA + .01893A -.07038S (r=.553, S.E.E.=137, P<.001). Based on this data, GMS half-time ranged from 0.81 to 5.13 hours with a mean of 1.82 hours. These findings have been incorporated into a computer program to permit computation of K2 for GMS with reasonable accuracy to allow initial or subsequent planning of GMS dosage regimens for sick newborn infants. (Research Support: USPHS #MB00146)
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Bernard, B., Cheney, N., Jelliffe, R. et al. PREDICTORS OF GENTAMICIN EXCRETION IN SICK NEWBORNS. Pediatr Res 11, 414 (1977). https://doi.org/10.1203/00006450-197704000-00270
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DOI: https://doi.org/10.1203/00006450-197704000-00270
