Extended-interval dosing of gentamicin for treatment of neonatal sepsis in developed and developing countries.
J Health Popul Nutr
;
2008 Jun; 26(2): 163-82
Article
in English
| IMSEAR
| ID: sea-754
ABSTRACT
Serious bacterial infections are the single most important cause of neonatal mortality in developing countries. Case-fatality rates for neonatal sepsis in developing countries are high, partly because of inadequate administration of necessary antibiotics. For the treatment of neonatal sepsis in resource-poor, high-mortality settings in developing countries where most neonatal deaths occur, simplified treatment regimens are needed. Recommended therapy for neonatal sepsis includes gentamicin, a parenteral aminoglycoside antibiotic, which has excellent activity against gram-negative bacteria, in combination with an antimicrobial with potent gram-positive activity. Traditionally, gentamicin has been administered 2-3 times daily. However, recent evidence suggests that extended-interval (i.e. >24 hours) dosing may be applicable to neonates. This review examines the available data from randomized and non-randomized studies of extended-interval dosing of gentamicin in neonates from both developed and developing countries. Available data on the use of gentamicin among neonates suggest that extended dosing intervals and higher doses (>4 mg/kg) confer a favourable pharmacokinetic profile, the potential for enhanced clinical efficacy and decreased toxicity at reduced cost. In conclusion, the following simplified weight-based dosing regimen for the treatment of serious neonatal infections in developing countries is recommended 13.5 mg (absolute dose) every 24 hours for neonates of >2,500 g, 10 mg every 24 hours for neonates of 2,000-2,499 g, and 10 mg every 48 hours for neonates of <2,000 g.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Body Weight
/
Female
/
Humans
/
Male
/
Infant, Newborn
/
Drug Administration Schedule
/
Gentamicins
/
Developed Countries
/
Treatment Outcome
/
Sepsis
Type of study:
Controlled clinical trial
/
Systematic reviews
Language:
English
Journal:
J Health Popul Nutr
Journal subject:
Gastroenterology
/
Nutritional Sciences
/
Public Health
Year:
2008
Type:
Article
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