Single-Dose Gentamicin Treatment of Recurrent Urinary Tract Infection in Children with Normal Urinary Tract

Abstract

Urinary tract infection (UTI) in children is usually treated with orally administered antibiotics for 7–10 days. Because of the unreliability of the patient compliance with the prescribed medications and because single-dose aminoglycoside therapy has been shown to be effective in adults with lower UTI, we conducted this retrospective study to asses efficacy of a single dose of gentamicin in patients with anatomically normal urinary tract, who had recurrent UTI.
In this study 79 episodes of UTI in 43 patients treated with gentamicin (41 with single-dose and 38 with conventional method of 7-10 days). All patients, except 7 (2 in conventional therapy and 5 in single-dose group), received both methods of therapy in different episodes of infection.
Isolated organisms from patients in single-dose group consisted of E. coli (90.4%), Klebsiella (7.3%), and miscellaneous bacteria (2.3%). In conventional therapy group E. coli (87%), Klebsiella (5.2%), and miscellaneous bacteria (7.8%) were isolated. E. coli was the most frequently isolated microorganism in both groups and sensitive to given antibiotics with no exception. 90.26 % of urine cultures were negative in single-dose group and 94.3 % in conventional therapy group 48-72 hours after treatment, the difference was statistically not significant (p=0.36).
Cumulative recurrence rate was 56 % in single-dose and 48.6% in conventional therapy group 6 weeks after treatment with no significant difference (p=64%).
Relapse rate (recurrence of the same organism and the same sensitivity as for the therapy begin) 6 weeks after treatment) was 57.3 % in single-dose and 33.5 % in conventional therapy group. This difference was also statistically not significant (p=26%).
No side effects could be detected in patients who had been treated with single-dose.
The results of the study allow the conclusion that in the absence of urinary tract malformations a single-dose treatment of UTI in children will be effective enough.