Gentamicin Therapeutic Drug Monitoring in Neonates Everything You Need to Know

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Learn how to optimize gentamicin therapeutic drug monitoring (TDM) in neonates to ensure safe and effective treatment. In this video, I break down: • The pharmacokinetic and pharmacodynamic factors affecting gentamicin in neonates. • The importance of extended-interval dosing to reduce toxicity and bacterial resistance. • When and how to monitor trough levels to optimize efficacy and minimize toxicity. • This evidence-based guide will give you the tools to apply TDM principles in practice and improve outcomes for your neonatal patients. • 📖 References: • Barnes V L, Heithoff DM, Mahan SP, et al. Antimicrobial susceptibility testing to evaluate minimum inhibitory concentration values of clinically relevant antibiotics. STAR Protoc. 2023;4(3):102512. • Bi GD, Li J, Nekka F. Antimicrobial breakpoint estimation accounting for variability in pharmacokinetics. Theor Biol Med Model. 2009;6:10. • Chaves BJ, Tadi P. Gentamicin. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NB... • Cho MH. Pediatric Acute Kidney Injury: Focusing on Diagnosis and Management. Child Kidney Dis. 2020;24(1):19-26. • De Rose DU, Cairoli S, Dionisi M, et al. Therapeutic Drug Monitoring Is a Feasible Tool to Personalize Drug Administration in Neonates Using New Techniques: An Overview on the Pharmacokinetics and Pharmacodynamics in Neonatal Age. Int J Mol Sci. 2020;21(16):5898. • de Velde F, Mouton JW, de Winter BCM, et al. Clinical Applications of population pharmacokinetic models of antibiotics: Challenges and perspectives. Pharmacol Res. 2018;134:280-288. • Ghoneim RH, Thabit AK, Lachkar MO, et al. Optimizing gentamicin dosing in different pediatric age groups using population pharmacokinetics and Monte Carlo simulation. Ital J Pediatr. 2021;47:167. • Hodiamont CJ, van den Broek AK, de Vroom SL, et al. Clinical Pharmacokinetics of Gentamicin in Various Patient Populations and Consequences for Optimal Dosing for Gram-Negative Infections: An Updated Review. Clin Pharmacokinet. 2022;61(8):1075-1094. • Hollander EM, van Tuinen EL, Schölvinck EH, et al. Evaluation of Dosing Guidelines for Gentamicin in Neonates and Children. Antibiotics (Basel). 2023;25;12(5):810. • Kowalska-Krochmal B, Dudek-Wicher R. The Minimum Inhibitory Concentration of Antibiotics: Methods, Interpretation, Clinical Relevance. Pathogens. 2021;10(2):165. • Le J, Greenberg RG, Benjamin DK, et al. Prolonged Post-Discontinuation Antibiotic Exposure in Very Low Birth Weight Neonates at Risk for Early-Onset Sepsis. J Pediatric Infect Dis Soc. 2021;10(5):615-621. • Lim WXS, Chua WBB, Chua JM, et al. A Retrospective Review of the Efficiency of First‐Dose Therapeutic Drug Monitoring of Gentamicin, Amikacin, and Vancomycin in the Pediatric Population. J Clin Pharmacol. 2020;60(1):7-15. • 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 Syst Rev. 2016;12(12):CD005091. • Sader HS, Mendes RE, Kimbrough JH, et al. Impact of the Recent Clinical and Laboratory Standards Institute Breakpoint Changes on the Antimicrobial Spectrum of Aminoglycosides and the Activity of Plazomicin Against Multidrug-Resistant and Carbapenem-Resistant Enterobacterales From United States Medical Centers. Open Forum Infect Dis. 2023;10(2):ofad058. • Shaffer CL, Davey AM, Ransom JL, et al. Ampicillin-Induced Neurotoxicity in Very-Low-Birth-Weight Neonates. Ann Pharmacother. 1998;32:482-484. • Tunkel AR, Hartman BJ, Kaplan SL, et al. Practice Guidelines for the Management of Bacterial Meningitis. Clin Infect Dis. 2004;39:1267-84. • van Donge T, Pfister M, Bielicki J, et al. Quantitative Analysis of Gentamicin Exposure in Neonates and Infants Calls into Question Its Current Dosing Recommendations. ASM. 2018;62(4):4-17. • van Maarseveen EM, Sprij A, Touw DJ. Extended-Interval Dosing of Gentamicin Aiming for a Drug-Free Period in Neonates: A Prospective Cohort Study. Ther Drug Monit. 2016;38(3):402-406. • 💡 Questions or topic ideas? Let me know in the comments! • 🔔 Subscribe for more evidence-based insights. • #pharmacology #neonatal #pediatrics #pharmacyeducation • Disclaimer: The content provided on this channel, Pharmacy Consult with Dr. Su, is for informational and educational purposes only, specifically intended for healthcare professionals. It is not a substitute for independent clinical judgment, professional advice, diagnosis, or treatment. Healthcare providers should exercise their own clinical judgment in interpreting and applying the information presented. Dr. Su is a licensed pharmacist; however, the information provided in these videos does not create a pharmacist-patient relationship. Reliance on any information provided by this channel is at your own risk. Always consult relevant guidelines and standards of practice before applying information from this channel.

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