Morbidity and mortality rates in premature infants treated with aminoglycosides in neonatal intensive care units: A comparative study

ABSTRACT

Objective: Aminoglycosides are used as first-line defense antibiotics in the Neonatal Intensive Care Unit (NICU) for the treatment of sepsis, meningitis, neonatal pneumonia, and endocarditis. However, they pose negative side effects such as ototoxicity, and nephrotoxicity, and the neuromuscular blockade effect is resulting from acetylcholine inhibition. In contrast to other antibiotics (such as vancomycin or meropenem), delayed weaning and weaning failure from artificial ventilation may be linked to neuromuscular blocking in neonates treated with aminoglycosides. However, the used dosing regimen and therapeutic guideline of aminoglycosides may provide optimal clinical outcomes. Methods: Data were obtained for 582 NICU patients with sepsis, birth asphyxia, respiratory distress syndrome, birth defects, infections or others, and who needed artificial ventilation. Included patients were divided into four groups: A, treated with amikacin; B, treated with gentamicin; C, treated with meropenem; and D, treated with vancomycin. The weaning duration, weaning failure rate, mortality rate, and length of hospital stay were compared. Results: Gentamicin showed the most positive effects in reducing the length of hospital stay and ventilation period of neonates with improved health conditions. In addition, the mortality rate was lowest in neonates treated with gentamicin as compared to other treatments. Conclusion: Our data elucidated that aminoglycosides, particularly gentamicin, with guidance was effective in improving the neonatal mortality and morbidity through reducing length of hospital stay and ventilation period without producing neuromuscular blocking action.

KEYWORDS

• Aminoglycosides
• Meropenem
• Vancomycin
• NICU
• Mortality
• Morbidity
• Ventilation
• Length of stay

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• DOI10.18549/PharmPract.2025.4.3342Copy

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