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. 2012 Jun;17(6):310-2.

Gentamicin in neonates at risk for sepsis - peak serum concentrations are not necessary

Luke F Reynolds  1 , Timothy L Mailman, Douglas D McMillan
Affiliations

Gentamicin in neonates at risk for sepsis - peak serum concentrations are not necessary

Luke F Reynolds et al. Paediatr Child Health. 2012 Jun.

Abstract
in English, French

Background: Serum gentamicin concentrations (GSCs) are frequently obtained before and after gentamicin administration to newborns with, or at high risk for, sepsis.

Objective: To determine whether performing a peak GSC assay when the trough GSC is within the guidelines for care would add clinically relevant information for health care workers.

Methods: A retrospective review of the IWK Health Centre (Halifax, Nova Scotia) laboratory database for peak and trough GSC for infants <28 days after birth was performed.

Results: Of 5253 paired samples of trough and peak GSCs, 3001 (57%) had trough GSCs ≤2 μg/mL. Of these, only nine (0.3%) had a peak GSC >10 μg/mL.

Conclusions: Performing a peak GSC measurement does not provide further clinically important data and increases patient morbidity and hospital costs.

Historique: On vérifie souvent les concentrations de gentamicine sérique avant et après l’administration de gentamicine aux nouveau-nés présentant une septicémie ou qui y sont très vulnérables.

Objectif: Déterminer si l’obtention de la valeur de pointe de la concentration de gentamicine sérique (CGS) lorsque la valeur seuil respecte les lignes directrices de soins ajoute de l’information pertinente sur le plan clinique pour les travailleurs de la santé.

Méthodologie: Analyse rétrospective de la base de données du laboratoire de l’IWK Health Centre à l’égard des valeurs de pointe et des valeurs seuils du CGS obtenues chez des bébés de moins de 28 jours de vie.

Résultats: Des 5 253 échantillons appariés, 3 001 (57 %) avaient une valeur seuil de la CGS égale ou inférieure à 2 μg/mL. De ce nombre, seulement neuf (0,3 %) avaient une valeur de pointe de la CGS supérieure à 10 μg/mL.

Conclusions: L’obtention de la valeur de pointe de la CGS ne fournit pas de nouvelles données importantes sur le plan clinique, sans compter qu’elle accroît la morbidité des patients et les coûts pour l’hôpital.

Keywords: Aminoglycoside; Cost-effectiveness; Dosing; Gentamicin; Neonate; Toxicity.

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