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Letters

Single or multiple daily doses of aminoglycosides

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7055.490 (Published 24 August 1996) Cite this as: BMJ 1996;313:490

More details needed of treatment in neonates and young children

  1. Harry Campbell, Senior lecturer
  1. Department of Public Health Sciences, University of Edinburgh, Medical School, Edinburgh EH8 9AG

    EDITOR,—I welcome Michael Barza and colleagues' paper comparing the use of single or multiple daily doses of gentamicin.1 This issue has considerable practical importance in developing countries because gentamicin is relatively cheap; it is thus typically the first line antibiotic used to treat (with benzylpenicillin) neonatal sepsis and neonatal meningitis and (with cloxacillin) staphylococcal pneumonia in young children.2 The paper, however, does not discuss how the findings should be interpreted for neonates or young children. The authors mention that two trials studied “a substantial number of children” but give no further details. They also report a risk ratio for the failure of treatment in a subgroup analysis of “paediatric patients.”

    I would be interested to know more details of the data relating specifically to neonates and young children. As the pharmacokinetics of gentamicin varies substantially with age (particularly in the neonatal period),3 4 5 the validity of extrapolating findings to young children, and in particular to neonates, is questionable. Given the importance of this issue, I would ask the authors to clarify whether they consider that the data support their general conclusions being applied to young children and specifically to neonates.

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