The aim of this study is to compare the renal damage caused by standard and once daily dose of Amikacin in premature infants with suspected sepsis.According to formula, the sample volume will be 40 infants. This study will be carried out in “Shahid Akbar Abadi” Hospital.
Inclusion criteria:Preterm infants with normal intrauterine growth
and sepsis suspicion at birth
Exclusion criteria:Neonate who received incomplete treatment ;Parents dissatisfaction for continuation of treatment;asphyxia;
renal anomalies in ultrasound after birth.
Preterm neonates with sepsis diagnosis will be divided to two groups (A and B) randomly. One group of neonates will receive standard dose of Amikacin and the other one, single daily dose. All of them will also receive 100 mg / kg / d Ampicillin each 8 or 12- hour. Before initializing the treatment, CBC, diff, blood culture, BUN, creatinine and urinary N-GAL will be checked. To rule out renal anomalies in infants during the first week after birth, ultrasound of the kidneys and urinary tract will be done. CBC, diff, BUN and creatinine will be rechecked on the third and fifth days of the treatment. In both groups, maximum and minimum of Amikacin serum level will be checked. The maximum Amikacin serum level will be reached 30 minutes after injection. With this sample the level of creatinine in the blood will also be checked. To determine the minimum level of Amikacin serum, sampling is done 30 minutes before the first injection of Amikacin on the fifth day. With this sample serum creatinine level is also measured. Urinary NGAL levels will be measured on the seventh day. Sampling will continue to the seventh day of treatment and until the number of children who have urinary N-GAL levels in each group (A and B) reaches 20.To study the adverse effects of Amikacin on kidneys, serum creatinine level and urinary N-GAL will be used.