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Dosing of aminoglycosides, once/twice daily?

Stefan Johansson

To a term infant with normal renal function, what's your dosing schedule for gentamycin/netilmycin?  

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Would like to hear how you dose aminoglycosides.

The Swedish Neonatal Association has published national guidelines on treatment of bacterial infections. Personally I think the document is well written and up-to-date with current practise internationally.

However, Karolinska is always Karolinska , and our clinical practise is characterized by some degree of conservatism (I am a bit diplomatic here).

So, we're having an argument regarding dosing of aminoglycosides. For example, if we need to treat a term infant, we discuss whether to administer netilmycin once daily (as the national guidelines suggest) or twice daily (our current practise).

What's your practise?

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We use AG once a day in term infants and check 30 minutes before using the third dose (but we wait for the result). In terms and preterm infants with compromised renal function (asphyxia, hypotension) we checked it sometimes earlier and more often. in preterms dosing is more difficult so depending to gestational week and age there are different doses and time periods (36 hr, 48 hr) to use. We always have good expierences and no toxic side effects. Always remember AGs needs, because of there properities, time with low blood levels for full action.

Greetings Bernhard Bungert

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Guest loweryp

For the term newborn dosing of gentamicin would on average be once a day in our unit. For all infants, the gent trough is checked prior to second dose which is administered when trough is </= 1.0 thus establishing dosing interval that avoids potential toxicities. So sometimes, gent is dosed less than once a day. We generally follow NeoFax dosing guidelines for all gestational ages.

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