Saddi Vishal, Preddy John, Dalton Sarah, Connors John, Patterson Sarah
Department of Paediatrics, Sydney Children's Hospital, Randwick; Discipline of Paediatrics and Child Health, University of New South Wales, Rural Medical School, Wagga Wagga; and Clinical Excellence Commission, Sydney, New South Wales, Australia.
Pediatr Qual Saf. 2017 Feb 17;2(2):e015. doi: 10.1097/pq9.0000000000000015. eCollection 2017 Mar-Apr.
Gentamicin is an aminoglycoside antibiotic with broad-spectrum bactericidal activity and is widely used in pediatric units to treat infection with susceptible organisms. This study aimed to describe the dosage regimen for gentamicin and approach to its therapeutic drug monitoring (TDM) among the pediatric units within the state of New South Wales (NSW).
A questionnaire was sent electronically to representatives of 40 pediatric units in NSW, requesting details of each unit's gentamicin dosing and TDM policy.
A total of 35 units responded to the survey. The majority (63%) of the units used a dose of 7.5 mg/kg of gentamicin in patients with normal renal function. More than half of the units (54%) did not have a local gentamicin dosing protocol and relied on other sources for dosing regimens. Dosing responses varied from a dose of 6 mg/kg once daily for patients more than 10 years of age to 7 mg/kg once daily on day 1, followed by 5 mg/kg once daily for patients over 10 years of age. For TDM of gentamicin, 63% of units indicated use of trough levels and 23% units used the Hartford Nomogram.
A significant variation exists in clinical practice among pediatric units in NSW on gentamicin dosing and TDM guidelines. There is an urgent need for collaboration among nursing, medical, and pharmacy experts to achieve consensus to develop and adopt statewide uniform guidelines on gentamicin dosing and TDM.
庆大霉素是一种具有广谱杀菌活性的氨基糖苷类抗生素，广泛应用于儿科病房以治疗易感病原体感染。本研究旨在描述新南威尔士州（NSW）各儿科病房的庆大霉素给药方案及其治疗药物监测（TDM）方法。
通过电子邮件向新南威尔士州40个儿科病房的代表发送问卷，询问各病房庆大霉素给药及TDM政策的详细信息。
共有35个病房回复了调查。大多数（63%）病房对肾功能正常的患者使用7.5mg/kg的庆大霉素剂量。超过一半的病房（54%）没有当地的庆大霉素给药方案，而是依赖其他来源获取给药方案。给药反应各不相同，10岁以上患者的剂量为每日一次6mg/kg，10岁以上患者第1天为每日一次7mg/kg，之后为每日一次5mg/kg。对于庆大霉素的TDM，63%的病房表示使用谷浓度，23%的病房使用哈特福德图谱。
新南威尔士州各儿科病房在庆大霉素给药和TDM指南方面的临床实践存在显著差异。迫切需要护理、医学和药学专家之间开展合作，以达成共识，制定并采用全州统一的庆大霉素给药和TDM指南。
