Aminoglycosides with beta-lactam antibiotics remain the first-line therapy in neonatal septicaemia, effective against aerobic, gram-negative organisms, with synergy against some gram-positive organisms. Aminoglycosides exhibit a concentration-dependant killing rate and a long post-antibiotic effect. An antibacterial peak concentration ([peak]) of >4 mcg/mL is ideal, with potential nephrotoxicity and ototoxicity, especially when the trough level ([trough]) exceeds 2 mcg/mL.
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