Route Intraventricular antibiotics are associated with increased mortality and should be avoided.(28) (LOE II, GOR B) General




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Intraventricular antibiotics are associated with increased mortality and should be avoided.(28) (LOE II, GOR B)



General

Aim to minimise aminoglycoside toxicity by (1) avoiding gentamicin to patients at elevated risk (i.e. on indomethacin, history of hypoxia and/or significant renal dysfunction), (2) minimising the duration of treatment and (3) prescribing a dose in a way that minimizes risk (i.e. EID with dose adjustment as necessary). (ANMF consensus recommendations)



References

  1. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive care medicine. 2017;43(3):304-77.

  2. Alshaikh B, Dersch-Mills D, Taylor R, Akierman AR, Yusuf K. Extended interval dosing of gentamicin in premature neonates ≤ 28-week gestation. Acta Paediatrica. 2012;101(11):1134-9.

  3. Dersch-Mills D, Akierman A, Alshaikh B, Yusuf K. Validation of a Dosage Individualization Table for Extended-Interval Gentamicin in Neonates. Annals of Pharmacotherapy. 2012;46(7-8):935-42.

  4. Dersch-Mills D, Akierman A, Alshaikh B, Sundaram A, Yusuf K. Performance of a dosage individualization table for extended interval gentamicin in neonates beyond the first week of life. The Journal of Maternal-Fetal & Neonatal Medicine. 2016;29(9):1451-6.

  5. Martínková J, Pokorná P, Záhora J, Chládek J, Vobruba V, Selke-Krulichová I, et al. Tolerability and outcomes of kinetically guided therapy with gentamicin in critically ill neonates during the first week of life: an open-label, prospective study. Clinical therapeutics. 2010;32(14):2400-14.

  6. Allegaert K. The impact of ibuprofen or indomethacin on renal drug clearance in neonates. The Journal of Maternal-Fetal & Neonatal Medicine. 2009;22(sup3):88-91.

  7. Smits A, De Cock RFW, Allegaert K, Vanhaesebrouck S, Danhof M, Knibbe CAJ. Prospective Evaluation of a Model-Based Dosing Regimen for Amikacin in Preterm and Term Neonates in Clinical Practice. Antimicrobial Agents and Chemotherapy. 2015;59(10):6344.

  8. Smits A, Kulo A, Van Den Anker J, Allegaert K. The amikacin research program: a stepwise approach to validate dosing regimens in neonates. 2016:1-10.

  9. Frymoyer A, Lee S, Bonifacio SL, Meng L, Lucas SS, Guglielmo BJ, et al. Every 36-h gentamicin dosing in neonates with hypoxic–ischemic encephalopathy receiving hypothermia. Journal of Perinatology. 2013;33(10):778-82.

  10. Bijleveld YA, De Haan TR, Van Der Lee HJH, Groenendaal F, Dijk PH, Van Heijst A, et al. Altered gentamicin pharmacokinetics in term neonates undergoing controlled hypothermia. British Journal of Clinical Pharmacology. 2016;81(6):1067-77.

  11. Lutz IC, Allegaert K, de Hoon JN, Marynissen H. Pharmacokinetics during therapeutic hypothermia for neonatal hypoxic ischaemic encephalopathy: a literature review. BMJ Paediatr Open. 2020;4(1):e000685-e.

  12. Cristea S, Smits A, Kulo A, Knibbe CAJ, van Weissenbruch M, Krekels EHJ, et al. Amikacin Pharmacokinetics To Optimize Dosing in Neonates with Perinatal Asphyxia Treated with Hypothermia. Antimicrobial Agents and Chemotherapy. 2017;61(12):e01282-17.

  13. Choi D, Park J, Lee S, An S. Effect of hypothermia treatment on gentamicin pharmacokinetics in neonates with hypoxic‐ischaemic encephalopathy: A systematic review and meta‐analysis. Journal of Clinical Pharmacy and Therapeutics. 2018;43(4):484-92.

  14. Raffaeli G, Pokorna P, Allegaert K, Mosca F, Cavallaro G, Wildschut E, et al. Drug disposition and pharmacotherapy in neonatal ECMO: from fragmented data to integrated knowledge. Frontiers in pediatrics. 2019;7:360.

  15. Gentamicin. Australian Injectable drug handbook 8th edition. (18 Spetember 2020).

  16. . MIMS online. (14 September 2020).

  17. Rao SC, Srinivasjois R, Moon K. One dose per day compared to multiple doses per day of gentamicin for treatment of suspected or proven sepsis in neonates. Cochrane Database of Systematic Reviews. 2016.

  18. Nestaas E. Aminoglycoside extended interval dosing in neonates is safe and effective: a meta-analysis. 2005;90(4):F294-f300.

  19. Moore RD, Smith CR, Lietman PS. The association of aminoglycoside plasma levels with mortality in patients with gram-negative bacteremia. Journal of infectious diseases. 1984;149(3):443-8.

  20. Moore RD, Smith CR, Lietman PS. Association of aminoglycoside plasma levels with therapeutic outcome in gram-negative pneumonia. The American journal of medicine. 1984;77(4):657-62.

  21. Kent A, Turner MA, Sharland M, Heath PT. Aminoglycoside toxicity in neonates: something to worry about? Expert Review of Anti-infective Therapy. 2014;12(3):319-31.

  22. Setiabudy R, Suwento R, Rundjan L, Yasin FH, Louisa M, Dwijayanti A, et al. Lack of a relationship between the serum concentration of aminoglycosides and ototoxicity in neonates. Int J Clin Pharmacol Ther. 2013;51(5):401-6.

  23. El-Barbary MN, Ismail RIH, Ibrahim AAA. Gentamicin extended interval regimen and ototoxicity in neonates. 2015;79(8):1294-8.

  24. Quiros Y, Vicente-Vicente L, Morales AI, López-Novoa JM, López-Hernández FJ. An integrative overview on the mechanisms underlying the renal tubular cytotoxicity of gentamicin. Toxicological sciences. 2011;119(2):245-56.

  25. Constance JE, Reith D, Ward R, Balch A, Stockmann C, Korgenski EK, et al. Risk of nonsteroidal anti-inflammatory drug-associated renal dysfunction among neonates diagnosed with patent ductus arteriosus and treated with gentamicin. Journal of Perinatology. 2017;37(10):1093-102.

  26. Wang X, Hong Y, Cai P, Tang N, Chen Y, Yan T, et al. Rapid and Reliable Detection of Nonsyndromic Hearing Loss Mutations by Multicolor Melting Curve Analysis. Scientific Reports. 2017;7(1):42894.

  27. Dean L. Gentamicin Therapy and MT-RNR1 Genotype: National Center for Biotechnology Information (US), Bethesda (MD); 2012 2012.

  28. Shah SS, Ohlsson A, Shah VS. Intraventricular antibiotics for bacterial meningitis in neonates. Cochrane Database of Systematic Reviews. 2012(7).

  29. Touw DJ, Westerman EM, Sprij AJ. Therapeutic Drug Monitoring of Aminoglycosides in Neonates. Clinical Pharmacokinetics. 2009;48(2):71-88.

  30. Kearns GL, Abdel-Rahman SM, Alander SW, Blowey DL, Leeder JS, Kauffman RE. Developmental pharmacology—drug disposition, action, and therapy in infants and children. New England Journal of Medicine. 2003;349(12):1157-67.

  31. Lacy MK, Nicolau DP, Nightingale CH, Quintiliani R. The pharmacodynamics of aminoglycosides. Clinical infectious diseases. 1998;27(1):23-7.

  32. Sullins AK, Abdel-Rahman SM. Pharmacokinetics of antibacterial agents in the CSF of children and adolescents. Pediatric Drugs. 2013;15(2):93-117.

  33. Dahlgren JG, Anderson ET, Hewitt WL. Gentamicin blood levels: a guide to nephrotoxicity. Antimicrobial agents and chemotherapy. 1975;8(1):58-62.

  34. Goodman EL, Van Gelder J, Holmes R, Hull AR, Sanford JP. Prospective comparative study of variable dosage and variable frequency regimens for administration of gentamicin. Antimicrobial Agents and Chemotherapy. 1975;8(4):434-8.

  35. de Hoog M, Mouton JW, van den Anker JN, editors. New dosing strategies for antibacterial agents in the neonate. Seminars in Fetal and Neonatal Medicine; 2005: Elsevier.



Original version Date: 08/08/2015

Author: NeoMed Consensus Group

Current Version number: 3

Version Date: 18/2/2021

Risk Rating: Low

Due for Review: 18/2/2026

Approval by: DTC

Approval Date:TBA




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Route Intraventricular antibiotics are associated with increased mortality and should be avoided.(28) (LOE II, GOR B) General

Download 1,5 Mb.