Demographic and Clinical Characteristics of Neonates at Risk of Gentamicin-induced Nephrotoxicity: A Single-Center Study in Sabah Women and Children Hospital

Abstract

Gentamicin is a clinically valuable aminoglycoside for the treatment of pneumonia, urinary tract infection, and neonatal sepsis empirically. The recommended dosage for gentamicin in pediatric guidelines is 4-7mg/kg in an extended interval of every 24-hourly or 36-hourly based on the subjects’ gestational age. This study aimed to describe the demographic and clinical characteristics of neonatal and pediatric patients that were at risk of gentamicin-related nephrotoxicity. This was a descriptive study conducted on all under 12-year-old pediatric patients who were on 5mg/kg gentamicin extended interval regimens and had elevated blood gentamicin trough levels of above 1.0mg/L. Out of the total 46 subjects, 24 were preterm babies and 27 had body weight of less than 2.5kg. The subjects were categorized into 2 groups: the 24-hourly group and the 36-hourly group. There were 32 (69.6%) subjects in the 24-hourly group and 14 (30.4%) in the 36-hourly group. 21 out of 32 subjects in the 24-hourly group were term babies whereas, all subjects in the 36-hourly group were preterm babies. Of all the 46 cases, gentamicin was served during the babies’ first week of life in 31 cases, and after the babies’ first week of life in 15 cases with 1 case of gentamicin being served to infants of 1 month old and above. It appeared that the incidence of gentamicin-related nephrotoxicity was slightly lower in the 36hourly group than the 24-hourly group. It is recommended to use the 5 mg/kg 36 hourly regimen for neonates in their first week of life when indicated.