ONCE-DAILY DOSING OF NETILMICIN IN NEONATAL AND PEDIATRIC INTENSIVE-CARE

Objective: To examine a once daily dosing regimen of netilmicin in cri tically ill neonates and children. Design and setting: Open, prospecti ve study on 81 antibiotic courses in 77 critically ill neonates and ch ildren, hospitalized in a multidisciplinary pediatric/neonatal intensi ve care unit. For combined empiric therapy (aminoglycoside and beta-la ctam), netilmicin was given intravenously over 5 min once every 24 h. The dose ranged from 3.5 - 6 mg/kg, mainly depending upon gestational and postnatal age. Peak levels were determined by immunoassay 30 min a fter the second dose and trough levels 1 h before the third and fifth dose or after adaptation of dosing. Results: All peak levels (n = 28) were clearly above 12 mumol/l (mean 22, range 13 - 41 mumol/l). Eighty -nine trough levels were within desired limits (<4 mumol/l) and 11 (11 %) above 4 mumol/l, mostly in conjunction with impaired renal function . Conclusions: Optimal peak and trough levels of netilmicin can be ach ieved by once daily dosing, adapted to gestational/postnatal age and r enal function.