Novel model-based dosing guidelines for gentamicin and tobramycin in preterm and term neonates

The Journal of Antimicrobial Chemotherapy
Pyry A J ValitaloCatherijne A J Knibbe

Abstract

In the heterogeneous group of preterm and term neonates, gentamicin and tobramycin are mainly dosed according to empirical guidelines, after which therapeutic drug monitoring and subsequent dose adaptation are applied. In view of the variety of neonatal guidelines available, the purpose of this study was to evaluate target concentration attainment of these guidelines, and to propose a new model-based dosing guideline for these drugs in neonates. Demographic characteristics of 1854 neonates (birth weight 390-5200 g, post-natal age 0-27 days) were extracted from earlier studies and sampled to obtain a test dataset of 5000 virtual patients. Monte Carlo simulations on the basis of validated models were undertaken to evaluate the attainment of target peak (5-12 mg/L) and trough (<0.5 mg/L) concentrations, and cumulative AUC, with the existing and proposed guidelines. Across the entire neonatal age and weight range, the Dutch National Formulary for Children, the British National Formulary for Children, Neofax and the Red Book resulted in adequate peak but elevated trough concentrations (63%-90% above target). The proposed dosing guideline (4.5 mg/kg gentamicin or 5.5 mg/kg tobramycin) with a dosing interval based on birth weight and ...Continue Reading

References

Oct 1, 1974·Antimicrobial Agents and Chemotherapy·E LabovitzD Kaye
May 15, 1980·The New England Journal of Medicine·C R SmithP S Lietman
Nov 14, 1997·Clinical Pharmacology and Therapeutics·M de HoogJ N van den Anker
Aug 23, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·George L DrusanoArnold Louie
Mar 21, 2009·The Journal of Antimicrobial Chemotherapy·Evan J BeggBrian Darlow
Jan 11, 2012·Clinical Pharmacokinetics·Roosmarijn F W De CockCatherijne A J Knibbe
May 30, 2014·The Journal of Antimicrobial Chemotherapy·Erik van MaarseveenDaniel Touw

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Citations

Apr 14, 2016·CPT: Pharmacometrics & Systems Pharmacology·R J AllenC J Musante
May 5, 2016·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Raffaele CoppiniKarel Allegaert
Dec 9, 2015·Antimicrobial Agents and Chemotherapy·Esther J H JanssenCatherijne A J Knibbe
Jan 18, 2018·International Journal of Clinical Pharmacy·T B Y LiemC M A Rademaker
Oct 26, 2016·Journal of Perinatology : Official Journal of the California Perinatal Association·J IbrahimN Hanna
Oct 28, 2016·Expert Review of Clinical Pharmacology·Manuel A BaarslagDick Tibboel
Jun 9, 2017·Journal of Perinatology : Official Journal of the California Perinatal Association·J E ConstanceC M T Sherwin
Apr 29, 2015·Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences·Roy M Anderson
Jul 15, 2015·Expert Opinion on Drug Metabolism & Toxicology·Elke H J KrekelsCatherijne A J Knibbe
Aug 2, 2017·Future Microbiology·Nazario D Rivera-ChaparroRachel G Greenberg
Feb 3, 2016·Therapeutic Drug Monitoring·Erik M van MaarseveenDaniel J Touw
Jun 9, 2016·Expert Review of Clinical Pharmacology·Janneke M BrusseeCatherijne A J Knibbe
Jul 19, 2017·Proceedings of the National Academy of Sciences of the United States of America·Syndi BarishJana L Gevertz
Jun 9, 2020·Paediatric Drugs·Robert B Flint, Karel Allegaert
May 24, 2018·Paediatrics and International Child Health·Aline FuchsJohannes N Van Den Anker
Feb 20, 2019·Healthcare·John van den Anker, Karel Allegaert
Aug 19, 2020·Acta Paediatrica·Janina MarissenUNKNOWN German Neonatal Network
Mar 26, 2021·Frontiers in Pharmacology·S D'AgateO Della Pasqua
Jun 30, 2021·Journal of Clinical Pharmacology·Jeffrey S BarrettAlexander A Vinks

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