Once daily dosing of netilmicin in neonatal and pediatric intensive care.
OBJECTIVE
To examine a once daily dosing regimen of netilmicin in critically ill neonates and children.


METHODS
Open, prospective study on 81 antibiotic courses in 77 critically ill neonates and children, hospitalized in a multidisciplinary pediatric/neonatal intensive care unit. For combined empiric therapy (aminoglycoside and beta-lactam), netilmicin was given intravenously over 5 min once every 24 h. The dose ranged from 3.5-6 mg/kg, mainly depending upon gestational and postnatal age. Peak levels were determined by immunoassay 30 min after the second dose and trough levels 1 h before the third and fifth dose or after adaptation of dosing.


RESULTS
All peak levels (n = 28) were clearly above 12 mumol/l (mean 22, range 13-41 mumol/l). Eighty-nine trough levels were within desired limits (< 4 mumol/l) and 11 (11%) above 4 mumol/l, mostly in conjunction with impaired renal function.


CONCLUSIONS
Optimal peak and trough levels of netilmicin can be achieved by once daily dosing, adapted to gestational/postnatal age and renal function.
Wagner
B P
BP
Intensive Care Unit, University Children's Hospital, Inselspital, Bern, Switzerland.
Pfenninger
J
J
D016638:Critical Illness; D004359:Drug Therapy, Combination; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D009428:Netilmicin / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics; D013997:Time Factors
D009428:Netilmicin