title: Should gentamicin trough levels be routinely obtained in term neonates?
abstract: Gentamicin is a common antibiotic used to treat sepsis in neonates. We hypothesize that obtaining routine gentamicin trough levels may not be necessary in low-risk, term infants.
  
  
  
  We performed a retrospective cohort study of term infants (n=346) treated with gentamicin in a single level III neonatal intensive care unit (NICU). The results of gentamicin trough levels and the correlation with risk factors and potential side effects were recorded. In addition, we conducted a survey of 75 academic NICUs across the United States regarding their gentamicin monitoring practice.
  
  
  
  Routine trough levels did not predict potential gentamicin toxicity in neonates with low risk factors. Regression analysis demonstrated a positive correlation between gentamicin trough levels and serum creatinine. The survey of the NICUs in the United States demonstrated significant inconsistency in gentamicin monitoring practice.
  
  
  
  Obtaining gentamicin trough levels guided by risk factors is more appropriate than obtaining routine trough levels in low-risk term neonates.
authors.affiliation: Division of Neonatal-Perinatal Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
authors.forename: J
authors.initials: J
authors.lastname: Ibrahim
authors.affiliation: Division of Neonatal-Perinatal Medicine, Cohen Children's Medical Center of NY, Long Island, NY, USA.
authors.forename: D
authors.initials: D
authors.lastname: Maffei
authors.affiliation: College of Pharmacy and Health Sciences, St John's University, Jamaica, NY, USA.|Department of Pharmacy, Winthrop University Hospital, Mineola, NY, USA.
authors.forename: G
authors.initials: G
authors.lastname: El-Chaar
authors.affiliation: Department of Biostatistics, Winthrop University Hospital, Mineola, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Islam
authors.affiliation: Department of Pediatrics, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Ponnaiya
authors.affiliation: Division of Neonatology, Department of Pediatrics, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Nayak
authors.affiliation: Department of Pediatrics, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: W
authors.initials: W
authors.lastname: Rosenfeld
authors.affiliation: Division of Neonatology, Department of Pediatrics, Children's Medical Center at Winthrop University Hospital, Mineola, NY, USA.
authors.forename: N
authors.initials: N
authors.lastname: Hanna
mesh_terms: D000073978:Academic Performance; D000900:Anti-Bacterial Agents / Q000097:blood* / Q000627:therapeutic use; D003401:Creatine / Q000097:blood; D016903:Drug Monitoring; D005260:Female; D005839:Gentamicins / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000517:prevention & control; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D003401:Creatine