Gentamicin 5 mg/kg/day single Daily Dose Administration in Children Aged 1-15 years
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Abstract: Aminoglycoside is a group of effective antibiotics against of gram negative and some gram positive organisms but the drug may have adverse reactions especially to the kidneys and vestibulocochlear organ, so many studies were carried out to find out which mode of drug administration can produce the most effective benefits and meanwhile reduce the adverse reactions. Due to their concentration dependent pharmacodynamics, single daily dose (SDD) drug administration would be one of the most suitable methods not only for higher peak level but also lower trough level. Since a few studies of aminoglycoside SDD in children were performed. I conducted this study by using gentamicin SDD regimen (5mg/kg/day), intravenous drip for 1 hour, in 98 pediatric patients, aged between 1-15 year who were admitted to Maharat Nakhon Ratchasima hospital during 1998 and 1999. The objectives were to evaluate peak and trough concentration level according to sex, age and neutrophil count, incidence of nephrotoxicity and efficacy of treatment in urinary tract infection (UTI) patients. The study showed mean peak concentration level was 10.28 ± 5.3 µg/ml and no statistical significance according to sex, age and neutrophil count. The mean trough level was 0.26 ± 0.4 µg/ml and females and children under 5 years of age had mean trough level higher than males and other age groups with statistical significance but there was no any difference according to neutrophil counts. Nephrotoxicity was not found in this study. The clinical bacteriological efficacy in UTI patients was 91.2% and 88.3% respectively. In conclusion, gentamicin 5 mg/kg/day, administered by SDD, in pediatric patients produced high peak and low trough level. Nephrotoxicity was not found in this study and the efficacy of treatment in UTI patients was good. So gentamicin administered by SDD would be a suitable method in children not only because of high efficacy and low toxicity but also because of the cost-effective benefit compared to the thrice daily dose (TID) conventional method.
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