Table 11.5Evidence profile for therapeutic drug monitoring based on serum creatinine concentrations in babies who received gentamicin by intravenous infusion in a neonatal intensive care unita

Number of studiesNumber of babiesEffectQuality
Serum creatinine guided therapeutic monitoringComparison groupRelative (95% confidence interval)Absolute (95% confidence interval)
Achievement of target ranges for serum gentamicin concentrations: peak concentration in the target range (4–10 mg/l)
All babies
1
(Reimche 1987)
19/22
(86%)
-NCNCVery low
Gestational age < 34 weeks
1
(Reimche 1987)
6/8
(75%)
-NCNCVery low
Gestational age34 weeks
1
(Reimche 1987)
13/14
(93%)
-NCNCVery low
Achievement of target ranges for serum gentamicin concentrations: peak concentration below the target range (< 4 mg/l)
All babies
1
(Reimche 1987)
3/22
(14%)
-NCNCVery low
Gestational age < 34 weeks
1
(Reimche 1987)
2/8
(25%)
-NCNCVery low
Gestational age34 weeks
1
(Reimche 1987)
1/14
(7%)
-NCNCVery low
Achievement of target ranges for serum gentamicin concentrations: peak concentration above the target range (> 10 mg/l)
All babies
1
(Reimche 1987)
1/22
(5%)
-NCNCVery low
Gestational age < 34 weeks
1
(Reimche 1987)
0/8
(0%)
-NCNCVery low
Gestational age ≥ 34 weeks
1
(Reimche 1987)
1/14
(7%)
-NCNCVery low
Achievement of target ranges for serum gentamicin concentrations: trough concentration in the target range (< 0.2 mg/l)
All babies
1
(Reimche 1987)
5/22
(23%)
-NCNCVery low
Gestational age < 34 weeks
1
(Reimche 1987)
1/8
(13%)
-NCNCVery low
Gestational age ≥ 34 weeks
1
(Reimche 1987)
4/14
(29%)
-NCNCVery low

NC not calculable

a

The gentamicin dose was fixed at 2.5 mg/kg throughout the study, and the initial dosing interval was 8, 12 or 18 hours depending on gestational age and postnatal age

See the complete GRADE Table J 11.5

From: 11, Therapeutic drug monitoring for gentamicin

Cover of Antibiotics for Early-Onset Neonatal Infection
Antibiotics for Early-Onset Neonatal Infection: Antibiotics for the Prevention and Treatment of Early-Onset Neonatal Infection.
NICE Clinical Guidelines, No. 149.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2012 Aug.
Copyright © 2012, National Collaborating Centre for Women’s and Children’s Health.

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