Should gentamicin trough levels be routinely obtained in term neonates?

Objective:gentamicin is a common antibiotic used to treat sepsis in neonates. we hypothesize that obtaining routine gentamicin trough levels may not be necessary in low-risk, term infants.study design:we performed a retrospective cohort study of term infants (n=346) treated with gentamicin in a single level iii neonatal intensive care unit (nicu). the results of gentamicin trough levels and the correlation with risk factors and potential side effects were recorded. in addition, we conducted a survey of 75 academic nicus across the united states regarding their gentamicin monitoring practice.results:routine trough levels did not predict potential gentamicin toxicity in neonates with low risk factors. regression analysis demonstrated a positive correlation between gentamicin trough levels and serum creatinine. the survey of the nicus in the united states demonstrated significant inconsistency in gentamicin monitoring practice.conclusion:obtaining gentamicin trough levels guided by risk factors is more appropriate than obtaining routine trough levels in low-risk term neonates.