Variation in gentamicin and vancomycin dosage and monitoring in UK neonatal units

Abstract

Gentamicin and vancomycin are commonly used in neonatal units for the treatment of life-threatening infections. This study aimed to describe the dosage regimen and the approach to therapeutic drug monitoring (TDM) for both antibiotics in units that participate in a UK neonatal network. Questionnaires were sent to all units across the Extended Neonatal Network, requesting details of each unit's dosing regimen and TDM practice. A total of 43 (of 114) units replied to the gentamicin questionnaire and 29 to the vancomycin questionnaire. Ten different gentamicin dosing regimens were used, depending on gestational age and weight. Most units (79%) followed British National Formulary for Children dosing guidance regarding vancomycin, but there were nine variations in TDM practice. There is significant variation in gentamicin and vancomycin dosing regimens and TDM guidance across a UK network of neonatal units. The development of standardized, evidence-based protocols should be prioritized.