Is monitoring plasma levels of netilmicin necessary in neonates?
Thirty-two neonates were treated with netilmicin 3 mg/kg every 12 h by IV infusion for 30 min for suspected infections, colonization, or proven infections. Pharmacokinetic studies were performed in order to define the situations in which monitoring of plasma levels would be appropriate. Mean plasma levels were within the therapeutic range and did not differ in fullterms and preterms. In the 4 children who had 2 successive pharmacokinetic studies, plasma levels were increased between H1 and H5 at the second evaluation due to netilmicin accumulation. Plasma half-life was longer in proven infections and seemed to decrease in preterms with increased gestational age. These results suggest that the dosage schedule should be left inchanged, but that administration time should be reduced from 30 to 20 min and that peak and trough plasma levels should be measured only in proven infections, in very premature babies (gestational age less than 33 wk), and during netilmicin treatment longer than 5 d.
Autret
E
E
Department of Clinical Pharmacology, CHU Tours, France.
Laugier
J
J
Breteau
M
M
Lionnet
C
C
Furet
Y
Y
D005260:Female; D005865:Gestational Age; D006207:Half-Life; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic; D009428:Netilmicin / Q000097:blood*
D009428:Netilmicin