Variation in Gentamicin Dosing and Monitoring in Pediatric Units across New South Wales.
Variation in Gentamicin Dosing and Monitoring in Pediatric Units across New South Wales.
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DOI：
10.1097/pq9.0000000000000015
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发表时间：
2017-03
影响因子：
1.1
通讯作者：
Patterson S
中科院分区：
文献类型：
--
作者：
Saddi V;Preddy J;Dalton S;Connors J;Patterson S
庆大霉素是一种具有广谱杀菌活性的氨基糖苷类抗生素，广泛用于儿科治疗敏感微生物感染。本研究旨在描述庆大霉素的给药方案及其在新南威尔士州（NSW）儿科单位中的治疗药物监测（TDM）方法。以电子方式向新南威尔士州40个儿科单位的代表发送了一份调查问卷，要求提供每个单位庆大霉素剂量和TDM政策的详细信息。共有35个单位对调查作出答复。在肾功能正常的患者中，大多数（63%）单位使用的庆大霉素剂量为7.5 mg/kg。超过一半的单位（54%）没有当地庆大霉素给药方案，并依赖于其他来源的给药方案。给药反应从6 mg/kg每日一次（10岁以上患者）至7 mg/kg每日一次（第1天）不等，随后是5 mg/kg每日一次（10岁以上患者）。对于庆大霉素的TDM，63%的单位表示使用谷水平，23%的单位使用Hartford列线图。新南威尔士州儿科单位在庆大霉素给药和TDM指南方面的临床实践存在显著差异。迫切需要护理、医疗和药学专家之间的合作，以达成共识，制定和采用全州统一的庆大霉素给药和TDM指南。
Gentamicin is an aminoglycoside antibiotic with broad-spectrum bactericidal activity and is widely used in pediatric units to treat infection with susceptible organisms. This study aimed to describe the dosage regimen for gentamicin and approach to its therapeutic drug monitoring (TDM) among the pediatric units within the state of New South Wales (NSW). A questionnaire was sent electronically to representatives of 40 pediatric units in NSW, requesting details of each unit’s gentamicin dosing and TDM policy. A total of 35 units responded to the survey. The majority (63%) of the units used a dose of 7.5 mg/kg of gentamicin in patients with normal renal function. More than half of the units (54%) did not have a local gentamicin dosing protocol and relied on other sources for dosing regimens. Dosing responses varied from a dose of 6 mg/kg once daily for patients more than 10 years of age to 7 mg/kg once daily on day 1, followed by 5 mg/kg once daily for patients over 10 years of age. For TDM of gentamicin, 63% of units indicated use of trough levels and 23% units used the Hartford Nomogram. A significant variation exists in clinical practice among pediatric units in NSW on gentamicin dosing and TDM guidelines. There is an urgent need for collaboration among nursing, medical, and pharmacy experts to achieve consensus to develop and adopt statewide uniform guidelines on gentamicin dosing and TDM.