Abstract
Emergence of a multiply drug resistant Enterobacter cloacae during a 7 week period in 1980 resulted in serious systemic disease in 4 infants and a high colonization rate in other infants in a newborn intensive care unit. Amikacin was employed as the aminoglycoside of choice in the initial treatment of suspected sepsis until the organism disappeared from the unit. Peak and trough serum amikacin levels were available in 18 infants. Recommended doses (7.5-10mg/kg loading; 15mg/kg bid IV) were given to 5 infants 1000gm infants (p = NS). These data show that surprisingly excessive blood levels of amikacin are likely in infants < 1000gm and may also occur in larger infants using currently recommended dosage schedules (J. Pediatr. 91:358, 1977). These unexpected findings emphasize the need to monitor drug levels and individualize therapy in very low birthweight infants.
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