Division of Neonatology, Department of Pediatrics, Faculty of Medicine, University of Calgary, Alberta, Canada.
Acta Paediatr. 2012 Nov;101(11):1134-9. doi: 10.1111/j.1651-2227.2012.02820.x. Epub 2012 Sep 7.
To evaluate an extended interval dosing (EID) regimen of gentamicin in neonates ≤28-week gestation.
In 2008, an EID regimen for gentamicin was introduced for all neonates admitted to the NICU in Calgary. The dosing interval was based on a 22 h level after the first dose of 5mg/kg. We conducted an observational study in 33 infants ≤28-week gestation on the EID regimen from the first day of life and compared gentamicin peak and trough levels with a historical control of 34 infants who received gentamicin in a dose of 2.5 mg/kg every 24 h (TID, traditional interval dosing).
In the EID group, based on the 22 h level, dosing interval was 36 h in 20 neonates and 48 h in 13 neonates. All neonates, except one, achieved therapeutic peak and trough levels. Compared to the TID group, the EID group had higher peak levels (median 9.8 μg/mL vs. 4.6 μg/mL, p < 0.001) with no difference in trough levels. With target peak levels of 5-12 μg/mL and trough levels of <2 μg/mL, a higher proportion of neonates in the TID group would need dose adjustment.
In neonates ≤ 28-week gestation, an EID regimen from day one of life, using a single level 22 h after the first dose for dosing interval, achieves therapeutic peak and trough levels and more optimum peak levels as compared to a TID regimen.
评估≤28 周龄新生儿的庆大霉素延长间隔给药（EID）方案。
2008 年，卡尔加里新生儿重症监护病房（NICU）开始为所有入院的新生儿采用 EID 庆大霉素方案。给药间隔基于首剂 5mg/kg 后 22 小时的水平。我们对 33 名≤28 周龄的新生儿进行了一项关于 EID 方案的观察性研究，这些新生儿从出生第一天开始使用 EID 方案，并将庆大霉素的峰值和谷值与接受 2.5mg/kg 每 24 小时（TID，传统间隔给药）的 34 名历史对照婴儿的庆大霉素峰值和谷值进行比较。
在 EID 组中，基于 22 小时的水平，20 名新生儿的给药间隔为 36 小时，13 名新生儿的给药间隔为 48 小时。除 1 名新生儿外，所有新生儿均达到治疗性的峰值和谷值。与 TID 组相比，EID 组的峰值更高（中位数 9.8μg/mL 比 4.6μg/mL，p<0.001），但谷值无差异。对于目标峰值为 5-12μg/mL 和谷值<2μg/mL，TID 组需要调整剂量的新生儿比例更高。
在≤28 周龄的新生儿中，从出生第一天开始采用 EID 方案，在首剂后 22 小时测定单次水平作为给药间隔，可达到治疗性的峰值和谷值，与 TID 方案相比，EID 方案的峰值更理想。
