Alimentary absorption of gentamicin in preterm infants

Fifty-two preterm neonates receiving oral gentamicin from birth, as prophylaxis against necrotizing enterocolitis (NEC), had serum gentamicin levels measured on the second day of life (52 infants) and on the seventh to tenth days (43 infants). The serum gentamicin concentrations on the second day were 0.5 microgram/ml or less in 21 percent, 0.6 to 1.0 microgram/ml in 15 percent, 1.1 to 2 micrograms/ml in 34 percent, 2.1 to 5 micrograms/ml in 25 percent, and 5 to 7.1 micrograms/ml in 4 percent of the infants. Paired serum gentamicin levels were significantly lower (p less than 0.001) on the seventh to tenth day as compared to the second day. We conclude that preterm infants in the first few days of life absorb orally administered gentamicin. Concomitant use of systemic gentamicin under such circumstances may potentially lead to toxic serum gentamicin concentration.