Neonatal drug monitoring and drug delivery systems.

The problems associated with drug delivery and achievement of therapeutic blood levels in neonates are reviewed, using chloramphenicol as an example. Administration of small volumes, concentrated solutions and intravenous line filter chambers greatly affect the final dose delivered to the infant. Once delivered, variability in drug elimination caused by changing hepatic and renal function and protein binding necessitate careful drug monitoring and pharmacokinetic analysis especially with drugs like chloramphenicol that have a narrow therapeutic range. If one uses a team approach involving nurses, clinical chemists and clinical pharmacologists, optimal doses of chloramphenicol in the newborn are achieved more consistently.