Related Experiment Video

Updated: Sep 20, 2026

Intrathecal Injection of Newborn Mouse for Genome Editing and Drug Delivery
04:33

Intrathecal Injection of Newborn Mouse for Genome Editing and Drug Delivery

Published on: March 8, 2024

Once daily gentamicin dosing in full term neonates

Saad A Alsaedi1

  • 1Department of Pediatrics, King Abdul-Aziz University Hospital, PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia. salsaedi@hotmail.com

Saudi Medical Journal
|September 16, 2003
PubMed

Insights

Once-daily gentamicin (4 mg/kg) is more effective and safer than twice-daily dosing (2.5 mg/kg) in term neonates. This optimized gentamicin regimen may reduce the need for serum drug level monitoring in infants with suspected sepsis.

Area of Science:

  • Neonatal pharmacology
  • Pediatric infectious diseases
  • Clinical pharmacokinetics

Background:

  • Current gentamicin dosing recommendations for neonates lack uniformity.
  • Gentamicin is a critical antibiotic for treating neonatal sepsis.

Purpose of the Study:

  • To compare the efficacy and safety of a once-daily gentamicin dosing regimen versus a twice-daily regimen in term neonates.
  • To evaluate serum gentamicin levels (SDL) and the need for dosing adjustments.

Main Methods:

  • A comparative study involving 100 term neonates (birth weight >/=2500 g) divided into two groups.
  • Control group (n=50): received gentamicin 2.5 mg/kg every 12 hours.
  • Protocol group (n=50): received gentamicin 4 mg/kg every 24 hours.
  • Trough and peak serum gentamicin levels were measured for all infants.

Main Results:

  • The once-daily regimen (4 mg/kg) achieved significantly higher peak SDL (8.4 mg/ml vs. 6.7 mg/ml) compared to the twice-daily regimen (2.5 mg/kg).
  • A higher percentage of infants in the once-daily group achieved therapeutic peak SDL (98% vs. 86%) and higher therapeutic range SDL (58% vs. 24%).
  • The once-daily regimen resulted in fewer infants with potentially toxic trough SDL (>2 mg/ml) (6% vs. 26%) and required fewer dosing adjustments (12% vs. 40%).

Conclusions:

  • A once-daily gentamicin dose of 4 mg/kg is superior to a twice-daily 2.5 mg/kg regimen in term neonates, achieving higher peak and safer trough serum concentrations.
  • Serum gentamicin concentration monitoring may not be necessary for once-daily dosing in term infants with suspected sepsis treated for 72 hours.
  • This optimized dosing strategy enhances therapeutic outcomes and potentially reduces healthcare resource utilization.
Abstract

More Related Videos

Galleria mellonella as an Antimicrobial Screening Model06:19

Galleria mellonella as an Antimicrobial Screening Model

Published on: October 11, 2024

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis08:46

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis

Published on: August 12, 2020

Related Concept Videos

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Dosage Regimen: Multiple Oral Dosage01:25

Dosage Regimen: Multiple Oral Dosage

Understanding how a drug's concentration fluctuates within the body over time is crucial in pharmacokinetics, particularly with multiple oral doses. A graphical representation of multiple oral dosages provides insight into these dynamics. Typical accumulation curves of a drug's concentration in the body reveal a sawtooth pattern, indicating periodic peaks and troughs correlating with each dose administration and the drug's subsequent elimination.The plasma concentration at any time during an...
IV Infusion to Oral Dosing: Conversion Methods01:28

IV Infusion to Oral Dosing: Conversion Methods

The development of extended-release formulations has facilitated the transition from intravenous to oral medication, offering a more convenient and patient-friendly approach to drug administration. This transition, however, requires careful management to ensure that therapeutic drug levels are maintained, preserving efficacy and avoiding adverse effects. Understanding pharmacokinetic principles and dosage calculations is critical during this process.Pharmacokinetics of the...
Dosage Interval and Administration Route: Determination Methods01:19

Dosage Interval and Administration Route: Determination Methods

A medication’s effectiveness largely depends on its appropriate dosage and the route of administration. Dosage ensures that a sufficient drug concentration is maintained in the bloodstream to elicit the desired therapeutic effect without causing toxicity. The route of administration affects the drug's bioavailability, rate of absorption, and onset of action, which are crucial for achieving optimal therapeutic outcomes. Drug dosage calculations are critical to tailoring therapy to individual...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...