Gentamicin is stable stored at 2c to 30c, but some product labels require controlled roomtemperature storage 20c to 25c. Aminoglycosides exhibit a concentrationdependant killing rate and a long. Clinical pharmacology of gentamicin in neonates medical express. Even short courses of gentamicin therapy in healty newborn infants can lead to. A brief guide to monitoring is at the bottom of this webpage. Patients who are obese should receive a relatively lower dose of gentamicin. Penicillin and gentamicin provided less coverage for gramnegative than grampositive isolates 86. May need dose adjustment monitor drug targets closely if.
Ertapenem 15 mgkg mg 12 hours no re dose na na gentamicin 2 mgkg no max 6 hours 12 hours 2. Use interval of q 36 hours for infants with hie or significant asphyxia. Neonatal drug doses 2016 this information about drug dosage, route and administration frequency should not be used without careful consideration of the characteristic of the individual case by the veterinary clinician. Gentamicin is a commonly used antibiotic that is very effective in treating bacterial infections in newborn babies. Pp45 gentamicin exposure in neonates according to swiss. Neonatal monograph gentamicin page 3 of 3 destroy printed copies after use. Extended interval dosing for gentamicin in neonates is safe and effective with a.
A pre dose level of dose level of 4 mgl may be considered to be subtherapeutic. Clinical pharmacokinetics of aminoglycosides in the. Preterm infants greater than or equal to 32 weeks postmenstrual age. Ibm watson health, greenwood village, colorado, usa. Neofax 2016 pdf free 395 download neofaxneofacs timminsneofacs kapuskasingneofacs jobsneofacs executive directorneofax pdfneofax bookneofax appneofax 2016 pdfneofax pdf free downloadneofax free downloadneofax gentamicinneofax book free downloadneofax latest editionneofax 2018neofax gentamicin dosing 1cbf73630d. However, as in any clinical situation, there may be. Neonates were subdivided according to gestational age and weight. Only 1 patient with a supratherapeutic peak value had received an inappropriately high gentamicin dose. Oncedailydosing intramuscular gentamicin in neonates dear editor, aminoglycosides with betalactam antibiotics remain the. Neonatal antimicrobial dosing at benioff childrens hospital. Recommended dose for all patients is 4 mgkg dose dosing intervals. Clinical pharmacokinetics of vancomycin in the neonate.
Gentamicin should be administered by direct iv injection over 3 5 minutes irrespective. Clinical pharmacokinetics of gentamicin in neonates mums. The manuscript was prepared according to the instructions for authors. Daly js, dodge ra, glew rh, keroack ma, bednarek fj, whalen m. Gentamicin injection 10 mgml gentamicin sulfate dose. Gentamicin is diluted to 2 mgml and infused over 30 minutes monitoring. A multicenter evaluation of gentamicin therapy in the. Destroy all printed copies of this monograph after use. Antibiotic use for sepsis in neonates and children world health.
Side effects of gentamicin pediatric gentamicin injection. Therapeutic guidelines for prescribing antibiotics in neonates should. Ototoxicity risk is difficult to predict and can occur despite target serum trough levels especially in infants with other risk factors. Aug 01, 2012 peak gentamicin levels were obtained for only 23 of the 33 patients administered inappropriately high gentamicin doses. Use the charts below for dosing of gentamicin and tobramycin only. Since aminoglycosides diffuse poorly into the subarachnoid space after parenteral administration, concentrations of gentamicin gentamicin injection pediatric in cerebrospinal fluid are often low and dependent upon dose, rate of penetration. Pre dose and peak serum levels of gentamicin were measured in 82 neonates 2542 weeks gestational age, and for comparison in 10 infants and 9 children. Recommended antimicrobial dosage schedules for neonates. Vancomycin is the preferred treatment of several neonatal staphylococcal infections. The clearance cl, serum halflife t12, and volume of distribution vd of aminoglycosides change during the neonatal life, and the. Guidelines for gentamicin dosing unitypoint health. In this initial study, which was comprised mostly of neonates 36 weeks ga, gentamicin pk peak and trough values were evaluated. Antibiotic dosing calculator for neonates and children trial sam holford1, carissa herbert1, brian anderson 2, nick holford3 1school of medicine.
Dose may be diluted in 510 ml of normal salineor injected directly. Poster sam holford antibiotic dosing calculator for neonates. In addition, the books neonatal formulary and neofax by young and. Amikacin, amphotericin b, gentamicin, other aminoglycosides. The gentamicin doses are 3 mgkg oncedaily for preterm newborns or 34 wk gestation. Gentamicin pediatric gentamicin injection pediatric. Gentamicin gentamicin injection pediatric injection is a sterile, nonpyrogenic, aqueous solution for parenteral administration and is available both with and without preservatives each ml of the preservative free product contains. Sepsis is common in neonates and is a major cause of morbidity and mortality. After institution of control measures that included the substitution of. Prophylaxis in neonates with documented risk factors. Measure serum concentrations when treating for more than 48 hours. Clinical pharmacology of gentamicin in infants and children.
Results mechanism of action of gentamicin gentamicin is rapidly bactericidal as it inhibits. Oncedailydosing intramuscular gentamicin in neonates. Ampicillin is a betalactam antibiotic and is the most commonly prescribed drug in hospitalized infants. In view of these results, the who recommendations for empiric penicillin and gentamicin for suspected neonatal meningitis should be revaluated. Pp45 gentamicin exposure in neonates according to swiss neo. Figure 1 for all male patients and figure 2 for all female patients below give suggested doses of gentamicin 5mgkg according to height and actual body weight and take into account a correction factor for obese. Gentamicin gentamicin injection pediatric sulfate, equivalent to gentamicin gentamicin injection pediatric 10 mg. Whether giving the full dose of gentamicin as a single dose per day is better than giving it as multiple small doses in a day in newborn babies. Not for use in patients with ascites, burns covering 20% of total body surface area, cystic fibrosis, endstage renal disease, endocarditis, infants, mycobacterial infections, or pregnancy. Effect of time and temperature on inactivation of aminoglycosides by ampicillin at neonatal dosages. An outbreak of serious infections due to gentamicinresistant klebsiella pneumoniae occurred in a neonatal intensive care unit in which the combination of gentamicin sulfate and ampicillin sodium had been used for standard initial therapy for suspected sepsis for nearly 11 years. Gentamicin monitoring is required once only, except when renal function is. Aug 09, 2019 an unusual decrease in the amount of your urine while using gentamicin injection pediatric. See guidance on gentamicin dosing in ekhuft antimicrobial policy for full details and other situations than single dose gentamicin in adults.
It kills bacteria by inhibiting protein synthesis and to some extent by lysing the cell envelope. Gentamicin and tobramycin dosing in neonates infectious. As previously mentioned, gentamicin is often used in neonates with hie undergoing hypothermia. Ceftriaxone, when given in a single daily dose, appears safe and effective in the treatment of bacterial meningitis in neonatal infants and children. Development of criteria for gentamicin monitoring in a. Neofax now available in hand or online now the neofax information you trust in the book is available ontine, making it the only resource of its kind for prescribing, calculating, formulating, and administering essential drug and parenteral nutrition solutions for neonates, for more patientspecific information, neofax premier is a musthave. Refer to the disclaimer state of queensland queensland health 2020 references 1. Neonatal antimicrobial dosing at benioff childrens. Antibiotic use for sepsis in neonates and children. Gentamicin vs cefotaxime for therapy of neonatal sepsis. Consider shortening the dose interval to 8hourly based on clinical judgement for example, if the baby appears very ill.
The dose calculator tool is intended to help in calculating initial gentamicin doses when creatine clearance can only be estimated. Neonatal formulary bmj books 6th edition 2011 p 120. Obtain peak concentration 30 minutes after end of infusion, and trough concentration 30 minutes prior to the next dose. None of the newborns with supratherapeutic peak values had elevated trough values. Aug 09, 2019 gentamicin gentamicin injection pediatric crosses the peritoneal as well as the placental membranes. All infants treated with gentamicin for longer than 48 hours should have audiology testing.
Dose determination and administration the standard prophylaxis dose is 3mgkg the standard treatment dose is 5mgkg, no single dose of gentamicin should exceed 520mg doses should be rounded down to the nearest 40mg the dose for neutropenic sepsis is 6mgkg, maximum dose at discretion of prescribing clinician. Gentamicin and tobramycin click here for dosing and interval meropenem usual. In addition, the books neonatal formulary 1 and neofax by young and mangum 3 were consulted. Jan 01, 2002 a pre dose level of dose level of 4 mgl may be considered to be subtherapeutic. It provides evidencebased drug information, age and indicationspecific drugdosing calculators and enteral formula nutritional information to help improve medication safety. It provides evidencebased drug information, age and indicationspecific drug dosing calculators, and enteral formula nutritional information to support clinicians providing neonatal and pediatric care. Ibm micromedex neofax and pediatrics is a web and mobile application.
Please consult a pediatric pharmacist for individualized dosing recommendations in infants with renal impairment. Hypothermic neonates had up to a 50% decrease in clearance compared with normothermic neonates. Copyright ibm corporation 2020 various trademarks held by their respective owners. Clinical pharmacology of ceftriaxone in infants and children. Click here to download a pdf version of the dosing card these dosing guidelines are intended for use at ucsf benioff childrens hospital san francisco. Sixty percent of preterm neonates receive at least one antibiotic, and 43% of the antibiotics administered to these neonates are aminoglycosides. Corrected gestational age weeks renal or cardiac dysfunction, use 2. Aminoglycoside dosing and monitoring chw this document reflects what is currently regarded as safe practice. G mycetin, garamycin gentamicin dosing, indications. For users who are not current neofax customers, the app is available for a fee. Neonatal sepsis is common and is a major cause of morbidity and mortality. Poster sam holford antibiotic dosing calculator for. Ibm micromedex neofaxpediatrics electronic version.