Tubular disorders in low birth weight neonates after prolonged antibiotic treatment.
BACKGROUND
Aminoglycosides (AGs) and vancomycin (VM) are potentially nephrotoxic antibiotics and their co-administration increases the incidence of nephrotoxicity in adult patients. Their combined effects on renal function in extremely low birth weight (ELBW) infants (<1,000 g) have not been previously reported.


OBJECTIVE
Investigation of tubular disturbances in five ELBW neonates following repeated and prolonged treatment with a variety of AGs combined with VM.


RESULTS
The drug levels were maintained in the neonatal therapeutic range. Renal tubular wasting of potassium, phosphate, and calcium, along with hypokalemia, was documented in all neonates studied while associated hypophosphatemia was observed in three of the five neonates and a transient rise in serum creatinine in four. The renal disturbances resolved completely 1-2 weeks after cessation of treatment.


CONCLUSIONS
Renal tubular disturbances due to AG and VM treatment in ELBW neonates may be more common than they are diagnosed. Early detection and appropriate electrolyte supplementation may help to normalize serum electrolyte levels in these infants.
Giapros
Vasileios I
VI
Neonatal Intensive Care Unit, Child Health Department, University of Ioannina, Ioannina, Greece. vgiapros@cc.uoi.gr
Papadimitriou
Foteini K
FK
Andronikou
Styliani K
SK
D000617:Aminoglycosides / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005865:Gestational Age; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced; D017674:Hypophosphatemia / Q000139:chemically induced; D007049:Iatrogenic Disease; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007674:Kidney Diseases / Q000139:chemically induced* / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D007684:Kidney Tubules / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D012189:Retrospective Studies; D014640:Vancomycin / Q000009:adverse effects*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D014640:Vancomycin; D003404:Creatinine