Urine output predicts serum gentamicin concentration in preterm infants

K. M. Oski, Mitchell Kresch, C. Kimble, D. Buchanan, N. Hussain

Research output: Contribution to journalArticle

Abstract

There are no reliable predictors of gentamicin (G) levels in premature infants. As G is excreted by the kidneys, we hypothesized G levels can be predicted by urine output. We conducted a retrospective study of neonates (GA 30-36wks, n= 20) who received G therapy (3 mg/kg/day). Infants with a Dx of acute tubular necrosis, asphyxia, hypotension or received vasopressor support or indomethacin were excluded. We collected data on gestational age (GA), body weight, urine output (UOP, cc/m2/hr and cc/k/hr), fluid intake and output (I/O), G intervals/route, body surface area, G levels and day of life G levels drawn. Volume of distribution (VD, liters) was calculated as dose given/[peak-trough] levels. Data were analyzed by student's test, chi square test, correlation coefficient as appropriate. Results showed urine output ≥2 and ≤ 4.0 cc/k/hr predicted therapeutic G levels (peak= 5-10 μg/mL) in premature infants (sensitivity 0.78, specificity 1 and positive predictive value 1). Urine output >4 cc/k/hr resulted in peak levels < 5 μg/mL. There were significant inverse correlations comparing peak G levels to UOP and VD (Table). We conclude that urine output, 24hrs prior to G level measurement, is a non-invasive, highly predictive measure of adequacy of dose. We also conclude that the inverse correlation of peak G levels with urine output reflects the change in volume of distribution. Table: Correlations of Peak Gentamicin (G) Concentrations UOP (cc/kg/hr) UOP (cc/m2/hr) VD r -0.572 -0.648 -0.49 r2 0.328 0.42 0.24 p value 0.008 0.002 0.03.

Original languageEnglish (US)
JournalJournal of Investigative Medicine
Volume47
Issue number2
StatePublished - 1999

Fingerprint

Gentamicins
Premature Infants
Urine
Level measurement
Serum
Indomethacin
Students
Gestational Age
Fluids
Body Surface Area
Asphyxia
Chi-Square Distribution
Hypotension
Necrosis
Retrospective Studies
Body Weight
Newborn Infant
Kidney
Sensitivity and Specificity
Therapeutics

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Oski, K. M. ; Kresch, Mitchell ; Kimble, C. ; Buchanan, D. ; Hussain, N. / Urine output predicts serum gentamicin concentration in preterm infants. In: Journal of Investigative Medicine. 1999 ; Vol. 47, No. 2.
@article{bb40b9e5ba414c4cb5f258a793eef41a,
title = "Urine output predicts serum gentamicin concentration in preterm infants",
abstract = "There are no reliable predictors of gentamicin (G) levels in premature infants. As G is excreted by the kidneys, we hypothesized G levels can be predicted by urine output. We conducted a retrospective study of neonates (GA 30-36wks, n= 20) who received G therapy (3 mg/kg/day). Infants with a Dx of acute tubular necrosis, asphyxia, hypotension or received vasopressor support or indomethacin were excluded. We collected data on gestational age (GA), body weight, urine output (UOP, cc/m2/hr and cc/k/hr), fluid intake and output (I/O), G intervals/route, body surface area, G levels and day of life G levels drawn. Volume of distribution (VD, liters) was calculated as dose given/[peak-trough] levels. Data were analyzed by student's test, chi square test, correlation coefficient as appropriate. Results showed urine output ≥2 and ≤ 4.0 cc/k/hr predicted therapeutic G levels (peak= 5-10 μg/mL) in premature infants (sensitivity 0.78, specificity 1 and positive predictive value 1). Urine output >4 cc/k/hr resulted in peak levels < 5 μg/mL. There were significant inverse correlations comparing peak G levels to UOP and VD (Table). We conclude that urine output, 24hrs prior to G level measurement, is a non-invasive, highly predictive measure of adequacy of dose. We also conclude that the inverse correlation of peak G levels with urine output reflects the change in volume of distribution. Table: Correlations of Peak Gentamicin (G) Concentrations UOP (cc/kg/hr) UOP (cc/m2/hr) VD r -0.572 -0.648 -0.49 r2 0.328 0.42 0.24 p value 0.008 0.002 0.03.",
author = "Oski, {K. M.} and Mitchell Kresch and C. Kimble and D. Buchanan and N. Hussain",
year = "1999",
language = "English (US)",
volume = "47",
journal = "Journal of Investigative Medicine",
issn = "1081-5589",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

Urine output predicts serum gentamicin concentration in preterm infants. / Oski, K. M.; Kresch, Mitchell; Kimble, C.; Buchanan, D.; Hussain, N.

In: Journal of Investigative Medicine, Vol. 47, No. 2, 1999.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Urine output predicts serum gentamicin concentration in preterm infants

AU - Oski, K. M.

AU - Kresch, Mitchell

AU - Kimble, C.

AU - Buchanan, D.

AU - Hussain, N.

PY - 1999

Y1 - 1999

N2 - There are no reliable predictors of gentamicin (G) levels in premature infants. As G is excreted by the kidneys, we hypothesized G levels can be predicted by urine output. We conducted a retrospective study of neonates (GA 30-36wks, n= 20) who received G therapy (3 mg/kg/day). Infants with a Dx of acute tubular necrosis, asphyxia, hypotension or received vasopressor support or indomethacin were excluded. We collected data on gestational age (GA), body weight, urine output (UOP, cc/m2/hr and cc/k/hr), fluid intake and output (I/O), G intervals/route, body surface area, G levels and day of life G levels drawn. Volume of distribution (VD, liters) was calculated as dose given/[peak-trough] levels. Data were analyzed by student's test, chi square test, correlation coefficient as appropriate. Results showed urine output ≥2 and ≤ 4.0 cc/k/hr predicted therapeutic G levels (peak= 5-10 μg/mL) in premature infants (sensitivity 0.78, specificity 1 and positive predictive value 1). Urine output >4 cc/k/hr resulted in peak levels < 5 μg/mL. There were significant inverse correlations comparing peak G levels to UOP and VD (Table). We conclude that urine output, 24hrs prior to G level measurement, is a non-invasive, highly predictive measure of adequacy of dose. We also conclude that the inverse correlation of peak G levels with urine output reflects the change in volume of distribution. Table: Correlations of Peak Gentamicin (G) Concentrations UOP (cc/kg/hr) UOP (cc/m2/hr) VD r -0.572 -0.648 -0.49 r2 0.328 0.42 0.24 p value 0.008 0.002 0.03.

AB - There are no reliable predictors of gentamicin (G) levels in premature infants. As G is excreted by the kidneys, we hypothesized G levels can be predicted by urine output. We conducted a retrospective study of neonates (GA 30-36wks, n= 20) who received G therapy (3 mg/kg/day). Infants with a Dx of acute tubular necrosis, asphyxia, hypotension or received vasopressor support or indomethacin were excluded. We collected data on gestational age (GA), body weight, urine output (UOP, cc/m2/hr and cc/k/hr), fluid intake and output (I/O), G intervals/route, body surface area, G levels and day of life G levels drawn. Volume of distribution (VD, liters) was calculated as dose given/[peak-trough] levels. Data were analyzed by student's test, chi square test, correlation coefficient as appropriate. Results showed urine output ≥2 and ≤ 4.0 cc/k/hr predicted therapeutic G levels (peak= 5-10 μg/mL) in premature infants (sensitivity 0.78, specificity 1 and positive predictive value 1). Urine output >4 cc/k/hr resulted in peak levels < 5 μg/mL. There were significant inverse correlations comparing peak G levels to UOP and VD (Table). We conclude that urine output, 24hrs prior to G level measurement, is a non-invasive, highly predictive measure of adequacy of dose. We also conclude that the inverse correlation of peak G levels with urine output reflects the change in volume of distribution. Table: Correlations of Peak Gentamicin (G) Concentrations UOP (cc/kg/hr) UOP (cc/m2/hr) VD r -0.572 -0.648 -0.49 r2 0.328 0.42 0.24 p value 0.008 0.002 0.03.

UR - http://www.scopus.com/inward/record.url?scp=33750113310&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750113310&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:33750113310

VL - 47

JO - Journal of Investigative Medicine

JF - Journal of Investigative Medicine

SN - 1081-5589

IS - 2

ER -