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Raymond D. Adelman, MD; Frederick Wirth, MD; Thomas Rubio, MD

Am J Dis Child. 1987;141(11):1175-1178.

Abstract
• The nephrotoxicity of the aminoglycoside amikacin sulfate was evaluated in an open, controlled study of newborns with presumed neonatal sepsis. One hundred twelve neonates were randomly allocated to receive either amikacin-ampicillin or mezlocillin, a semisynthetic penicillin. Neonates receiving amikacin, in contrast to those receiving mezlocillin, showed significant nephrotoxicity as evidenced by a delayed postnatal fall in mean serum creatinine level (82 to 80 µmol/L [0.93 to 0.90 mg/dL] vs 84 to 72 µmol/L [0.95 to 0.82 mg/dL]) and a delayed postnatal rise in mean creatinine clearance per kilogram of body weight (12% vs 38%). Furthermore, 40% of neonates receiving amikacin-ampicillin compared with 19% of neonates receiving mezlocillin had a decline in creatinine clearance (>25%). There was no relationship between amikacin nephrotoxicity and either peak or trough amikacin levels. In summary, in a controlled study of the use of amikacin and mazlocillin in neonates, the combination of amikacin and ampicillin proved more nephrotoxic to the newborn kidney.

(AJDC 1987;141:1175-1178)

Author Affiliations
From the Departments of Pediatrics, University of California, Davis (Dr Adelman), and Eastern Virginia Medical School, Norfolk (Drs Wirth and Rubio).

Footnotes
Accepted for publication June 7, 1987.

Reprint requests to the Department of Pediatrics, University of California, Davis, Medical Center, 4301 X St, Sacramento, CA 95817 (Dr Adelman).

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