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Dear All, 

I wanted to know your unit’s antibiotic choice in 22-23 week babies. We use Benzyl Penicillin and Gentamicin. Dose of Gentamicin is 5 mg/kg/dose @ 36 hourly interval. However we’ve seen actuate kidney injuries with this dosage and we’re wondering whether to change to cefotaxime instead. Would be grateful for your input.

On 4/6/2022 at 6:56 PM, dramitkan said:

Dear All, 

I wanted to know your unit’s antibiotic choice in 22-23 week babies. We use Benzyl Penicillin and Gentamicin. Dose of Gentamicin is 5 mg/kg/dose @ 36 hourly interval. However we’ve seen actuate kidney injuries with this dosage and we’re wondering whether to change to cefotaxime instead. Would be grateful for your input.

Empirical treatment of the first choice is Ampicilin/Gentamcin

  • 2 weeks later...

Ampicillin/Gentamicin

Gentamicin 5 mg/kg every 48h hours according to the dosage handbook of the American pharmacists association 

  • Author
On 4/12/2022 at 7:14 PM, Vicky Payne said:

Cefotaxime first line for EOS in Southampton. 

Hi Vicky

Do you use Cefotaxime monotherapy?

On 4/6/2022 at 8:26 PM, dramitkan said:

Dear All, 

I wanted to know your unit’s antibiotic choice in 22-23 week babies. We use Benzyl Penicillin and Gentamicin. Dose of Gentamicin is 5 mg/kg/dose @ 36 hourly interval. However we’ve seen actuate kidney injuries with this dosage and we’re wondering whether to change to cefotaxime instead. Would be grateful for your input.

We use Ampicillin and Amikacin 

kindly review your Gentamicin dosage in this clinical context can you please high light acute kidney injury is it dose related Acute tubular necrosis? 
please update thank you 

  • 1 month later...
On 5/4/2022 at 5:49 PM, Vicky Payne said:

Yes- we would add in amoxicillin if concerns re: listeria. 

No aminoglycoside....

Hi Vicky

That's interesting as it will save doing drug levels and medications errors as well.

My questions

- how long since you intoduced this  as 1st line for EOS

- what's the microbiology advice regarding resisitance as you know most of other units use cefotaxime and vanc as 3rd line Abx.

- What's your second and third line Abx policy .

Thanks again

Gentamycin / Ampicillin. Intervall and Dose acorrding to Neofax. Through Level measuring before second Dose (who determine also peak level?). No 3. Generation Cephalosporines because reported higher appearence of ESBL bacteria. 

I can’t tell you how long we’ve used cefotaxime for- but definitely 10 years.
 

You are best speaking to a colleague of mine for more details- if you want to message me your email address I can pass it on?  Microbiology data monitored and I assume no concerns with ESBLs!

second line fluclox and gent or vanc and gent if a central line present. 

  • 2 weeks later...

We use amp and gent. With gent doses of 4mg q 48 hours.

We haven't experienced any kidney failure.

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