Prospective Audit of Gentamicin Drug Monitoring Practice in a Pediatric Cancer Center

Background Many pediatric cancer centers still use Gentamicin as first line combination treatment in patients with fever and neutropenia. Since 2011, our center has implemented a dosing regimen with 250 mg/m (2) BSA (max. 10 mg/kg, max. 400 mg) as a single daily infusion according to the German guideline. Patients and Methods In this prospective audit (February 2011 to December 2019), 105 Gentamicin treatment cycles were analyzed in 66 pediatric cancer patients, focusing on adherence to the dosing regimen and the drug monitoring results. Results Adherence to the dosing regimen was high (89%). In 64% of all cycles, the C (max) (drawn 1 h after the 2 (nd) dose) reached the target of 10-20 mu g/ml. C (max) significantly correlated with dosing in mg/m (2) BSA (p=0,007), but not with dosing in mg/kg (p=0,366). Age below 6 years did not influence these results. The Gentamicin C (trough) (drawn 8-10 h after the second dose) was < 2 mu g/ml in 93% of all cycles without any dose correlation. None of the patients experienced Gentamicin-associated nephrotoxicity. Discussion and Conclusion This prospective audit of single daily infusion Gentamicin in pediatric cancer patients without impaired renal function elicits the feasibility and safety of the dosing regimen in mg/m (2) BSA according to the German guideline. Since indications for first-line gentamicin are limited, a multicenter prospective study would be advantageous to confirm these observations.

Automated summary

This study investigated the dosing regimen of single daily infusion Gentamicin in pediatric cancer patients. The results showed high adherence to the dosing regimen, with a high proportion of cycles reaching the target C (max) levels, and no patients experiencing nephrotoxicity.