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Marissen J, Erdmann H, Böckenholt K, et al. Aminoglycosides were associated with higher rates of surgical patent ductus arteriosus closure in preterm infants [published online ahead of print, 2020 Aug 18]. Acta Paediatr. 2020;10.1111/apa.15541. doi:10.1111/apa.15541

Aim: In animal studies, aminoglycosides induced ductus arteriosus relaxation in a dose-dependent fashion. We tested the hypothesis that antibiotic treatment of preterm infants with aminoglycosides is associated with higher rates of surgical patent ductus arteriosus (PDA) closure.

Methods: Preterm infants (birth weight <1000 grams or gestational age <29 weeks) enrolled in 62 German neonatal intensive care units (NICUs) were analysed. NICUs were stratified according to the use of aminoglycosides as first line antibiotics.

Results: Baseline data were not different when NICUs using aminoglycosides (n=9965 infants) were compared to NICUs using other antibiotics (n=1948 infants). Rates of surgical PDA closure were 5.9% for NICUs using aminoglycosides; 6.2% for units using gentamicin and 5.0% for NICUs using tobramycin compared to 4.1% in NICUs using other antibiotics (p<0.001, p<0.001 and p=0.140 respectively, Fisher’s exact test). Indomethacin and ibuprofen use was more common in NICUs using aminoglycosides (41% versus 33%, p<0.001, Fisher’s exact test). Gentamicin trough levels were higher in NICUs with surgical closure rates above the mean (median 2.0 µg/ml, inter-quartile-range 0.8-4.0 µg/ml versus 1.2 µg/ml, IQR 0.8-1.7, p<0.001, Mann-Whitney U test).

Conclusion: First line antibiotic treatment of preterm infants with aminoglycosides was associated with higher rates of surgical PDA closure.

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