Fifty children aged 3 months-16 y with Gram-negative bacterial infecti
ons, were evaluated in this open randomized study; 26 received gentami
cin 4.5 mg/kg/day, once daily, and 24 received the same daily dosage,
in three divided doses. The groups had similar demographic and clinica
l characteristics. Serum trough gentamicin concentrations were signifi
cantly lower in the od group than in the tds group, while peak concent
ration were significantly higher in the od group. Clinical cure was ob
tained in 23 of the 26 (88.8%) children who received gentamicin once d
aily, and in 22/24 (91%) children treated thrice daily. Microbiologica
l cure was obtained in 10/10 (100%) and 12/13 (92%) of the evaluated c
ases. Nephrotoxicity was not observed but ototoxicity occurred in two
children in each group. These results, although obtained from a small
number of patients, showed a similar outcome in children receiving gen
tamicin 45 mg/kg/day whether administered once or thrice daily.