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?

if we are treating full term baby with normal function tests,we are applying : twice daily....

Give Aminoglycoside to NB twice daily.

For a term infant we give once a day, which leads me to ask, when do you take levels (we routinely take prior to the third dose)

For a term infant we give once a day, which leads me to ask, when do you take levels (we routinely take prior to the third dose)

We check a serum level before the second dose.

For term infant with normal renal function we used to give once daily dosing.

To term infant we give garamycin once daily and check level before the third dose if we continue antibiotic treatment.

Hi

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

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.

The only aminoglycoside we use is amikacin . We follow NEOFAX religiously.