Gentamicin
Neonatal

Neonatal

Gestational age <30 weeks
  • Postnatal age ≤ 14 days: 5 mg/kg every 48 hours
  • Postnatal age >14 days: 5 mg/kg every 36 hours
Gestational age 30-34 weeks
  • Postnatal age ≤ 10 days: 5 mg/kg every 36 hours
  • Postnatal age > 10 days: 5 mg/kg every 24 hours
Gestational age ≥ 35 weeks
  • Postnatal age ≤7 days: 4 mg/kg every 24 hours
  • Postnatal age ˃7 days: 5 mg/kg every 24 hours

Therapeutic drug Monitoring (TDM)

Trough levels are obtained just prior to the next anticipated dose and are a safety measure.

TDM is not necessary if therapy is anticipated to stop at 36-48 hours.

A trough level can be obtained just prior to the anticipated second dose but may be postponed to pre-third dose if there is no concern for renal dysfunction and if it is anticipated that the duration will be ≤ 48 hours. Trough levels are then usually obtained before every subsequent third dose of aminoglycosides.

Target for Trough concentrations:

<2.0 mg/L

Peak concentrations are not routinely needed unless for purposes of pharmacokinetic modelling or efficacy.

If renal dysfunction is present, consult clinical pharmacist as longer dosing intervals and/or lower doses may be required if the aminoglycoside is to be continued.

Considerations for Renal Dysfunction or Acute HIE/Asphyxia

  • 3 mg/kg/dose x 1 dose
  • Consult pharmacist for further interval recommendations