Assessment of gentamicin 7 mg/kg once daily for pediatric patients with febrile neutropenia: a pilot project

Context. Use of once daily aminoglycosides continues to increase for the pediatric population, including oncology patients. Concerns have been identified and still need to be resolved including the optimal dose, frequency, and monitoring parameters.

Objective. We completed a study to determine if empiric use of gentamicin 7 mg/kg once daily in pediatric patients admitted with febrile neutropenia provided extrapolated peaks and drug-free intervals consistent with suggested preferred levels.

Design. A review of the patient’s chart was completed following their discharge from the hospital between September 2006 and October 2007.

Setting. A community hospital.

Patients. A consecutive sample of 17 encounters for pediatric patients admitted for febrile neutropenia that received once daily gentamicin.

Main outcome measures. Extrapolated peak levels and drug-free intervals.

Results. There were seven patients with a total of 17 encounters. The mean extrapolated peak level was 16.9 mg/L. The mean drug-free interval was 15.7 h. Both target peak and drug-free interval were obtained for two encounters (12%), which was one patient.

Conclusion. Gentamicin 7 mg/kg/dose once daily does not provide preferred levels for all pediatric febrile neutropenic patients. Further investigation is required to ensure that once daily gentamicin regimens for pediatric oncology patients provide adequate clinical success. J Oncol Pharm Practice (2009) 15: 211—216.