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Tubular disorders in low birth weight neonates after prolonged antibiotic treatment

Vasileios I Giapros1, Foteini K Papadimitriou, Styliani K Andronikou

  • 1Neonatal Intensive Care Unit, Child Health Department, University of Ioannina, Ioannina, Greece. vgiapros@cc.uoi.gr

Neonatology
|March 9, 2007
PubMed

Insights

Combined antibiotic treatment with aminoglycosides (AGs) and vancomycin (VM) in extremely low birth weight (ELBW) infants can cause kidney problems. These renal tubular disturbances, including electrolyte wasting, resolved after stopping the drugs.

Area of Science:

  • Neonatal Medicine
  • Pharmacology
  • Nephrology

Background:

  • Aminoglycosides (AGs) and vancomycin (VM) are critical antibiotics for neonatal infections but carry nephrotoxicity risks.
  • Co-administration of AGs and VM is common in adult patients, increasing nephrotoxicity.
  • The impact of combined AG and VM therapy on renal function in extremely low birth weight (ELBW) infants (<1,000 g) remains underreported.

Observation:

  • This study investigated tubular dysfunction in five ELBW neonates receiving prolonged, repeated courses of combined AGs and VM.
  • Drug levels were consistently maintained within the therapeutic neonatal range throughout treatment.

Findings:

  • All studied neonates exhibited renal tubular wasting of potassium, phosphate, and calcium, leading to hypokalemia.
  • Hypophosphatemia was observed in three neonates, and transient elevations in serum creatinine occurred in four.
  • All documented renal disturbances resolved completely within 1-2 weeks after treatment cessation.

Implications:

  • Renal tubular disturbances from AG and VM treatment may be more prevalent in ELBW neonates than currently recognized.
  • Early identification of these subclinical renal effects is crucial for timely intervention.
  • Appropriate electrolyte supplementation can effectively manage and normalize serum electrolyte levels in affected infants.
Abstract

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