High compared with standard gentamicin dosing for chorioamnionitis

A comparison of maternal and fetal serum drug levels

Gregory J. Locksmith, Anita Chin, Tammy Vu, Karen Shattuck, Gary Hankins

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

OBJECTIVE: To compare umbilical cord and maternal serum peak gentamicin concentration, gentamicin elimination, and clinical outcomes between women who received once-daily compared with standard, thrice-daily dosing for clinical chorioamnionitis. METHODS: We randomly assigned 38 laboring women, at least 34 weeks gestation, with clinical chorioamnionitis, into 1 of 2 gentamicin dosing groups: 5.1 mg/kg every 24 hours (once-daily; n = 18), or 120 mg followed by 80 mg every 8 hours (standard; n = 20). We measured maternal serum peak and delivery gentamicin concentrations and cord serum levels at delivery. Polynomial curve fitting was used to summarize gentamicin elimination. We also compared maternal and neonatal outcomes. RESULTS: Demographic characteristics of the 2 groups were similar. Median maternal peak gentamicin levels were higher with once-daily (18.2 μg/mL) compared with standard dosing (7.1 μg/mL) (P < .001). Maternal serum levels decreased below 2 μg/mL by 10 hours in the once-daily group and by 5 hours in the standard dosing group. Extrapolated peak cord serum levels were 6.9 μg/mL in the once-daily and 2.9 μg/mL in the standard dosing arm. Cord levels decreased below 2 μg/mL by 10 hours in the once-daily and by 5 hours in the standard dosing group. We found no differences in maternal or neonatal outcomes. CONCLUSION: Peak maternal serum gentamicin levels ranged from 13 to 25 μg/mL after a dose of 5.1 mg/kg. Single-dose gentamicin resulted in fetal serum peak levels that were closer to optimal neonatal values. Gentamicin clearance in the term fetus was similar to published values for the newborn infant. No adverse effects of high-dose therapy were noted.

Original languageEnglish (US)
Pages (from-to)473-479
Number of pages7
JournalObstetrics and Gynecology
Volume105
Issue number3
DOIs
StatePublished - Mar 2005
Externally publishedYes

Fingerprint

Chorioamnionitis
Gentamicins
Mothers
Serum
Pharmaceutical Preparations
Umbilical Cord
Fetus
Demography
Newborn Infant
Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

High compared with standard gentamicin dosing for chorioamnionitis : A comparison of maternal and fetal serum drug levels. / Locksmith, Gregory J.; Chin, Anita; Vu, Tammy; Shattuck, Karen; Hankins, Gary.

In: Obstetrics and Gynecology, Vol. 105, No. 3, 03.2005, p. 473-479.

Research output: Contribution to journalArticle

Locksmith, Gregory J. ; Chin, Anita ; Vu, Tammy ; Shattuck, Karen ; Hankins, Gary. / High compared with standard gentamicin dosing for chorioamnionitis : A comparison of maternal and fetal serum drug levels. In: Obstetrics and Gynecology. 2005 ; Vol. 105, No. 3. pp. 473-479.
@article{3f21438ce3f142eba3a21be06a3d9c05,
title = "High compared with standard gentamicin dosing for chorioamnionitis: A comparison of maternal and fetal serum drug levels",
abstract = "OBJECTIVE: To compare umbilical cord and maternal serum peak gentamicin concentration, gentamicin elimination, and clinical outcomes between women who received once-daily compared with standard, thrice-daily dosing for clinical chorioamnionitis. METHODS: We randomly assigned 38 laboring women, at least 34 weeks gestation, with clinical chorioamnionitis, into 1 of 2 gentamicin dosing groups: 5.1 mg/kg every 24 hours (once-daily; n = 18), or 120 mg followed by 80 mg every 8 hours (standard; n = 20). We measured maternal serum peak and delivery gentamicin concentrations and cord serum levels at delivery. Polynomial curve fitting was used to summarize gentamicin elimination. We also compared maternal and neonatal outcomes. RESULTS: Demographic characteristics of the 2 groups were similar. Median maternal peak gentamicin levels were higher with once-daily (18.2 μg/mL) compared with standard dosing (7.1 μg/mL) (P < .001). Maternal serum levels decreased below 2 μg/mL by 10 hours in the once-daily group and by 5 hours in the standard dosing group. Extrapolated peak cord serum levels were 6.9 μg/mL in the once-daily and 2.9 μg/mL in the standard dosing arm. Cord levels decreased below 2 μg/mL by 10 hours in the once-daily and by 5 hours in the standard dosing group. We found no differences in maternal or neonatal outcomes. CONCLUSION: Peak maternal serum gentamicin levels ranged from 13 to 25 μg/mL after a dose of 5.1 mg/kg. Single-dose gentamicin resulted in fetal serum peak levels that were closer to optimal neonatal values. Gentamicin clearance in the term fetus was similar to published values for the newborn infant. No adverse effects of high-dose therapy were noted.",
author = "Locksmith, {Gregory J.} and Anita Chin and Tammy Vu and Karen Shattuck and Gary Hankins",
year = "2005",
month = "3",
doi = "10.1097/01.AOG.0000151106.87930.1a",
language = "English (US)",
volume = "105",
pages = "473--479",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - High compared with standard gentamicin dosing for chorioamnionitis

T2 - A comparison of maternal and fetal serum drug levels

AU - Locksmith, Gregory J.

AU - Chin, Anita

AU - Vu, Tammy

AU - Shattuck, Karen

AU - Hankins, Gary

PY - 2005/3

Y1 - 2005/3

N2 - OBJECTIVE: To compare umbilical cord and maternal serum peak gentamicin concentration, gentamicin elimination, and clinical outcomes between women who received once-daily compared with standard, thrice-daily dosing for clinical chorioamnionitis. METHODS: We randomly assigned 38 laboring women, at least 34 weeks gestation, with clinical chorioamnionitis, into 1 of 2 gentamicin dosing groups: 5.1 mg/kg every 24 hours (once-daily; n = 18), or 120 mg followed by 80 mg every 8 hours (standard; n = 20). We measured maternal serum peak and delivery gentamicin concentrations and cord serum levels at delivery. Polynomial curve fitting was used to summarize gentamicin elimination. We also compared maternal and neonatal outcomes. RESULTS: Demographic characteristics of the 2 groups were similar. Median maternal peak gentamicin levels were higher with once-daily (18.2 μg/mL) compared with standard dosing (7.1 μg/mL) (P < .001). Maternal serum levels decreased below 2 μg/mL by 10 hours in the once-daily group and by 5 hours in the standard dosing group. Extrapolated peak cord serum levels were 6.9 μg/mL in the once-daily and 2.9 μg/mL in the standard dosing arm. Cord levels decreased below 2 μg/mL by 10 hours in the once-daily and by 5 hours in the standard dosing group. We found no differences in maternal or neonatal outcomes. CONCLUSION: Peak maternal serum gentamicin levels ranged from 13 to 25 μg/mL after a dose of 5.1 mg/kg. Single-dose gentamicin resulted in fetal serum peak levels that were closer to optimal neonatal values. Gentamicin clearance in the term fetus was similar to published values for the newborn infant. No adverse effects of high-dose therapy were noted.

AB - OBJECTIVE: To compare umbilical cord and maternal serum peak gentamicin concentration, gentamicin elimination, and clinical outcomes between women who received once-daily compared with standard, thrice-daily dosing for clinical chorioamnionitis. METHODS: We randomly assigned 38 laboring women, at least 34 weeks gestation, with clinical chorioamnionitis, into 1 of 2 gentamicin dosing groups: 5.1 mg/kg every 24 hours (once-daily; n = 18), or 120 mg followed by 80 mg every 8 hours (standard; n = 20). We measured maternal serum peak and delivery gentamicin concentrations and cord serum levels at delivery. Polynomial curve fitting was used to summarize gentamicin elimination. We also compared maternal and neonatal outcomes. RESULTS: Demographic characteristics of the 2 groups were similar. Median maternal peak gentamicin levels were higher with once-daily (18.2 μg/mL) compared with standard dosing (7.1 μg/mL) (P < .001). Maternal serum levels decreased below 2 μg/mL by 10 hours in the once-daily group and by 5 hours in the standard dosing group. Extrapolated peak cord serum levels were 6.9 μg/mL in the once-daily and 2.9 μg/mL in the standard dosing arm. Cord levels decreased below 2 μg/mL by 10 hours in the once-daily and by 5 hours in the standard dosing group. We found no differences in maternal or neonatal outcomes. CONCLUSION: Peak maternal serum gentamicin levels ranged from 13 to 25 μg/mL after a dose of 5.1 mg/kg. Single-dose gentamicin resulted in fetal serum peak levels that were closer to optimal neonatal values. Gentamicin clearance in the term fetus was similar to published values for the newborn infant. No adverse effects of high-dose therapy were noted.

UR - http://www.scopus.com/inward/record.url?scp=13944252124&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13944252124&partnerID=8YFLogxK

U2 - 10.1097/01.AOG.0000151106.87930.1a

DO - 10.1097/01.AOG.0000151106.87930.1a

M3 - Article

VL - 105

SP - 473

EP - 479

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 3

ER -