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Is a once daily dose of gentamicin safe and effective in the treatment of uti in infants and children?

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An 8-month-old infant is admitted with fever and vomiting. Urinary tract infection (UTI) is diagnosed. You decide to commence IV treatment with gentamicin. In your paediatric ward, gentamicin is routinely administered in three times daily dose (TD) regimens but you look up gentamicin administration in the BNF for children and find that it can be given once daily (OD). This prompts debate amongst staff as to whether the same can be done on your ward. Everyone wonders whether there is any supportive evidence for efficacy and safety when OD gentamicin is used in the treatment of UTI.

Structured clinical question

In children aged 1 month to 18 years with UTI [patients], is OD gentamicin [intervention] as compared with TD gentamicin [comparator] as effective in resolving UTI and as safe [outcome]?

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Secondary sources

Cochrane database, DARE, ACP Journal Club …

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