Serum calcium values in term and late-preterm neonates receiving gentamicin

Area of Science:

• Neonatal Medicine
• Pharmacology
• Clinical Chemistry

Background:

• Gentamicin is a common antibiotic used in neonates.
• Prolonged gentamicin therapy may be associated with adverse effects.
• Hypocalcemia has been anecdotally observed in neonates on gentamicin.

Purpose of the Study:

• To prospectively monitor and retrospectively analyze serum calcium levels in neonates receiving prolonged gentamicin therapy.
• To determine the incidence and risk factors for hypocalcemia in this population.

Main Methods:

• Retrospective analysis of serum calcium values from neonates receiving >= 4 days of gentamicin.
• Inclusion criteria: gestational age >= 35 weeks, serum calcium measured >= 47 hours after therapy initiation.
• Statistical analysis included Student t-test, chi-square, and Pearson correlation.

Main Results:

• 1,624 neonates met criteria; 15% (241) had hypocalcemia (serum Ca < 8 mg/dl).
• Hypocalcemia was more frequent in boys (16.4%) vs girls (11.8%) and in neonates < 37 weeks GA (23.9%) vs >= 37 weeks GA (14.1%).
• Of those with initial hypocalcemia, 23.2% remained low, and 30% received oral calcium supplementation.

Conclusions:

• Hypocalcemia is not uncommon in neonates treated with gentamicin for >= 4 days.
• Boys and late-preterm infants are at increased risk.
• Serum calcium monitoring should be considered for neonates on prolonged gentamicin therapy.