Journal of Antimicrobial Chemotherapy (2002) 49, 13-16
© 2002 The British Society for Antimicrobial Chemotherapy
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Newborns and gentamicin—how much and how often?
Medical Microbiology Department, Whipps Cross University Hospital NHS Trust, Leytonstone, London E11 1NR, UK
Aminoglycosides are widely used in the treatment of suspected or proven severe bacterial infections. Combined with ß-lactam antibiotics, gentamicin provides synergic activity against the most commonly encountered pathogens in the first month of life, including the frequently isolated coagulase-negative staphylococci. The clinical use of aminoglycosides is limited, unfortunately, by their potential ototoxicity and nephrotoxicity.1 Nevertheless, their concentration-dependent bactericidal action and post-antibiotic effect, antibacterial synergy with ß-lactams and low cost, and the better understanding of risk factors associated with the use of these agents, are favourable points for their continued use. The risk of aminoglycoside-induced nephrotoxicity and ototoxicity, although controversial in newborns, must still be considered a potential hazard related to drug accumulation.2–4 Until substantial evidence proves otherwise, maintaining serum gentamicin concentrations within the accepted therapeutic range in newborns continues to be prudent.
In order to obtain optimal therapeutic effect and to prevent potential toxicity associated with high post-dose and pre-dose
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