Objective: Aminoglycoside antibiotics have a narrow margin of safety between therapeutic and toxic levels. The current study used multiple frequency bioelectrical impedance analysis to develop prediction equations for gentamicin distribution space in neonates.
Methods: Gentamicin pharmacokinetic parameters and bioimpedance were measured in 14 infants in the neonatal intensive care unit. Stepwise regression analysis was used to develop predictive models, using impedance quotients (F2/R), weight and gestational age as variables, whose predictive performance was then tested in a second group of ten infants.
Results: The prediction model with the smallest bias and highest concordance correlation was that which included F2/R0 and weight. This bias of 50 ml or 6.7% was less than half of that found using a model including weight alone.
Conclusion: A bioelectrical impedance-based prediction equation for prediction of gentamicin distribution space in neonates was produced. Although this prediction equation represents only a small improvement over that using weight alone, this is of clinical significance due to the narrow margin between therapeutic and toxic levels for gentamicin. A clinical trial to confirm the value of this methodology is now warranted.