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The reference value for trough gentamicin levels after gentamicin infusion is < 0.5 mg/L.
Nine of the 31 babies with 24 hour trough gentamicin levels >1 mg/l had a "random" concentration below the regression line.
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A trough gentamicin level <1 mg/l was significantly associated with increasing gestational age (P < 0.0001 by χ).
Five millilitres of blood will be taken just prior to draining in the dialysate with gentamicin to measure the true 'trough' gentamicin levels.
1 mg/l or less was considered as an acceptable trough gentamicin concentration.
Thirty-one of the 50 babies had a 24 hr trough gentamicin concentration > 1 mg/L.
For this reason, we aimed to achieve trough gentamicin concentrations of ≤ 1 mg/L.
Trough gentamicin concentrations were taken at 24 hours after the first dose, before a steady state was reached.
As the nomogram failed to be a useful predictor of trough gentamicin concentrations <1 mg/l, we re-analysed the data.
Table 2 shows the performance characteristics for predicting trough gentamicin concentrations <1 mg/l for the nomogram and for gestational age.
20 of the ICUs (75%) used trough levels to guide gentamicin re-dosing and the remaining 7 (25%) used a nomogram.
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