Bonifasius Siyuka Singu
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Milka Ndapandula Ndeunyema
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Ene Ikpong Ette
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Clarissa Hildegard Pieper
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Roger Karel Verbeeck
Abstract
Gentamicin and amikacin are aminoglycoside antibiotics which are renally excreted and known to cause nephrotoxicity. Neonatal eGFR per body surface area is lower than in adults and exposure to nephrotoxic drugs could lead to more suppression in kidney function. The aim of this study was to investigate the effect of administering successive courses of gentamicin (first-line) and amikacin (second-line) therapy on neonatal kidney function. Data were collected from patient records of neonates receiving gentamicin (July-December 2019) and amikacin (July-December 2020) at the Neonatal Unit of Windhoek Central Hospital (Namibia). 44 neonates on gentamicin and 35 on amikacin were included in this study. Aminoglycoside dose was administered as a slow intravenous bolus and two blood samples taken for pharmacokinetic analysis. Other information collected: gestational age, postnatal age (PNA), weight, height, serum creatinine, and dosage regimen. Primary outcomes were correlation of eGFR with PNA, and the time it took to clear the drug to < 1 µg/mL; eGFR was calculated using the Schwartz method. The negative correlation between eGFR and PNA was significant (r = -0.370, p = 0.034). Therapeutic range Cmax were achieved in 27.3% gentamicin neonates (15–25 µg/mL), and 17.1% in amikacin (55–65 µg/mL). Proportion of neonates with a Cmin <1 µg/mL within the 24-hour dosage interval were 72.7% and 82.9% for gentamicin and amikacin, respectively. Conclusion: The decline in kidney function for neonates while on amikacin was significant. However, a considerably high proportion of amikacin neonates (82.9%) were able to clear the drug to < 1 µg/mL within 24 hours.
Effect of Successive Gentamicin and Amikacin Therapies on Renal Function of Neonates
