Single daily dose of gentamicin in the treatment of pediatric urinary tract infection

Abstract

Fourty-nine patients aged 6 months to 12 years old with suspected urinary tract infection (UTI) were evaluated in this open randomized study. Twenty-seven patients received gentamicin 4.5 mg/kg/d once daily (OD group) and 22 patients received the same daily dose in three divided doses (TID group) for 3 days before being switched to amoxy-clavulanic acid. Ninety-six per cent (26/27) of the OD group had peak gentamicin within therapeutic level while 40 per cent (9/22) of the TID group had peak gentamicin within therapeutic level. One in OD group had high gentamicin level due to technical error in obtaining blood sample. None in neither group had trough level in toxic level. Only 24 patients had confirmed UTI and were evaluated for clinical efficacy and toxicity. Demographic data were the same in both groups except there were more males in OD group (8:3 vs 4:9). Patients in OD group became afebrile earlier than TID group (8.69 vs 15.31 hours) but no statistically significant difference. All patients had negative urine culture results within 48 hours. None had clinical nephrotoxicity in both groups. More patients in TID group had laboratory nephrotoxicity (5/11 vs 2/13) but no statistically significant difference. We conclude that gentamicin can be given safely and efficiently as single daily dose or thrice daily but more cost effective and less time consuming in once daily dose.