Safety of intravenous bolus administration of gentamicin in pediatric patients

OBJECTIVE: TO determine the safety of gentamicin administered intravenously as a bolus. METHODS: All patients (n = 123, ages: up to 18y, 121; 21y, 1; 31y, 1) who r eceived gentamicin intravenously as a bolus over a four-month period were s tudied retrospectively. Patient demographics, type of infection, dosing reg imen, length of therapy, peak and trough serum concentrations, blood urea n itrogen. serum creatinine, and urine output were reviewed. Patients were st ratified into four groups and data analyzed statistically. RESULTS: Mean initial dose (5.32 +/- 2.38 mg/kg/d) was consistent with esta blished guidelines for age and kidney development, with subsequent adjustme nts based on serum concentrations. Susceptible organisms were eradicated wi th a mean length of therapy of 6.9 +/- 6.9 days (range 1-35). Patients rece ived a median of nine doses: 42% received doses every eight hours and 33% r eceived doses every 24 hours. No relationship between dosing and abnormal s erum creatinine were found (p = 0.69). The estimated cost savings mainly fr om less nursing time and lower equipment and supply use were $50/patient wi th bolus administration of gentamicin. CONCLUSIONS: Intravenous bolus administration was safe if pediatric patient s and was associated with lower costs.