Gentamicin in Neonates with Hemodynamically Significant Patent Ductus Arteriosus

Area of Science:

• Neonatal Cardiology
• Pharmacokinetics
• Neonatal Pharmacology

Background:

• Gentamicin may cause vasodilation, potentially affecting ductus arteriosus (DA) closure.
• Hemodynamically significant patent ductus arteriosus (hsPDA) is common in preterm neonates.
• hsPDA may alter gentamicin pharmacokinetics and trough concentrations.

Purpose of the Study:

• To evaluate the association between gentamicin use and hsPDA closure in neonates treated with acetaminophen.
• To assess the effect of hsPDA on gentamicin trough concentrations.

Main Methods:

• Prospective observational study of 60 neonates with hsPDA and 102 without.
• Echocardiography used to diagnose hsPDA and assess DA size.
• Gentamicin dosing, duration, and trough concentrations were recorded.

Main Results:

• Neonates with hsPDA received longer gentamicin therapy durations but lower daily doses.
• No significant differences in gentamicin trough concentrations were found between groups.
• Gentamicin use was not associated with hsPDA closure, but longer duration correlated with successful closure.

Conclusions:

• Neonates with hsPDA require longer gentamicin therapy durations.
• Concomitant gentamicin administration did not significantly affect hsPDA closure rates.
• No significant impact of hsPDA on gentamicin trough concentrations was observed.