[Gentamicin administration in newborns: once daily]

Area of Science:

• Neonatal pharmacology
• Antibiotic pharmacokinetics
• Pediatric infectious diseases

Context:

• Gentamicin is a critical antibiotic for treating neonatal infections.
• Optimizing gentamicin dosing is essential to maximize efficacy and minimize toxicity in neonates.
• Previous dosing regimens require evaluation for improved therapeutic outcomes.

Purpose:

• To compare serum gentamicin levels in neonates receiving once-daily versus twice-daily dosing.
• To determine the optimal gentamicin dosage regimen for achieving therapeutic trough and peak plasma levels in newborns.
• To assess the impact of dosing frequency on gentamicin efficacy and safety in premature and non-premature neonates.

Summary:

• A retrospective and prospective study analyzed gentamicin trough and peak plasma levels in 82 neonates.
• Neonates receiving a once-daily dose (4 mg/kg/day) demonstrated significantly higher adequate trough and peak levels compared to those on a twice-daily regimen.
• Optimal gentamicin levels were achieved more frequently with the once-daily schedule, particularly in premature infants.

Impact:

• The findings support a revised gentamicin dosing guideline for neonates.
• A once-daily administration of 4.0 mg/kg/day is recommended for neonates to improve therapeutic drug monitoring and patient outcomes.
• This study contributes to evidence-based neonatal pharmacotherapy, potentially reducing treatment failures and adverse effects.