Gentamicina en dosis única diaria frente a tres dosis diarias en lactantes con pielonefritis aguda
- C. Calvo Rey
- B. García Díaz
- V. Nebreda Pérez
- M.L. García García
- A.I. Maderuelo Sánchez
- M.L. Cilleruelo Pascual
- C. García Lacalle
ISSN: 1695-4033, 1696-4608
Year of publication: 2003
Volume: 58
Issue: 3
Pages: 228-231
Type: Article
More publications in: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Abstract
Background Once-daily dosing (ODD) of gentamicin is advocated as an effective and safe treatment of Gram-negative bacterial infections in adults. There are insufficient data in the liter-ature to justify its use in infants. Objectives To compare the efficacy of ODD of gentamicin with that of classical thrice-daily (t.i.d.) administration in infants with acute pyelonephritis. Methods We performed a quasi-experimental study comparing 33 infants who received ODD of gentamicin with a histor-ical control group of 25 infants treated with gentamicin t.i.d. Leukocytosis, C-reactive protein, creatinine, gentamicin dose, peak and trough values, time required for disappearance of fever, and outcome were analyzed. Results The mean doses of gentamicin (mg/kg/day) were higher in the t.i.d. group (6.4 6 1.14) than in the ODD group (5.06 6 0.22; p< 0.001). Peak serum gentamicin concentrations (µg/ml) were significantly higher in the ODD group (9.32 6 1.4) than in the t.i.d. group (5.09 6 1.15; p < 0.001). Mean trough gentamicin concentrations (µg/ml) were lower in the ODD group than in the t.i.d. group (0.23 6 0.26 vs 0.78 6 0.45; p 5 0.001). There were no significant differences in the duration of fever between the groups (30.64 6 32 hours in the t.i.d. group vs. 28.57 6 32 hours in the ODD group). Serum creatinine levels were normal during treatment in both groups. In all patients outcome was good and no adverse effects were noted. Conclusions Treatment with ODD of gentamicin in our population of infants with acute pyelonephritis was as effective as tra-ditional administration t.i.d. and possibly was equally safe or safer.