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Single dose gentamicin treatment of urinary infections in children

K Grimwood1, G D Abbott, D M Fergusson

  • 1Department of Paediatrics, Christchurch School of Medicine.

The New Zealand Medical Journal
|August 24, 1988
PubMed

Insights

Single dose gentamicin therapy for pediatric urinary tract infections showed similar effectiveness to seven-day courses but with less disruption to gut flora. However, relapses were more common with single-dose treatment.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacology
  • Microbiology

Background:

  • Urinary tract infections (UTIs) are common in children.
  • Conventional antibiotic courses for pediatric UTIs can be lengthy.
  • Gut flora disruption is a potential side effect of antibiotic therapy.

Purpose of the Study:

  • To compare the efficacy and safety of single-dose gentamicin versus a seven-day antibiotic course for pediatric UTIs.
  • To assess the impact of each treatment regimen on rectal and periurethral flora.
  • To identify factors influencing treatment response in children with UTIs.

Main Methods:

  • Randomized trial involving 69 children with UTIs.
  • Comparison of single-dose gentamicin (n=39) against a seven-day antibiotic course (n=30).
  • Assessment of treatment response over six weeks, considering clinical diagnosis, history, and radiological abnormalities.
  • Microbiological analysis of rectal and periurethral flora.

Main Results:

  • No significant difference in treatment response between single-dose and seven-day regimens.
  • Single-dose gentamicin caused significantly less suppression of rectal and periurethral flora.
  • Children with recurrent infections or radiological abnormalities showed poorer treatment outcomes.
  • A trend towards relapse in the single-dose group and reinfection in the conventional therapy group was observed.

Conclusions:

  • Single-dose gentamicin is a viable alternative for pediatric UTIs, offering reduced microbial disruption.
  • Treatment effectiveness is comparable to conventional seven-day courses, but relapse risk needs consideration.
  • Patient factors like infection history and radiological findings significantly impact UTI treatment success.

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