Gentamicin pediatric patients

Dosages recommended are for patients with normal renal function See Table 37-3 for appropriate dosage of gentamicin "Pediatric dose should not exceed that of a normal adult See text and Table 37-3 for appropriate dosage of vancomycin... 

Robinson RF, Nahata MC. Safety of intravenous bolus administration of gentamicin in pediatric patients. Ann Pharmacother 2001 35(11) 1327-31. 

Some drugs may be less toxic in pediatric patients than in adults. Aminoglycosides appear to be less toxic in infants than in adults. In adults, aminoglycoside toxicity is related to both peripheral compartment accumulation and the individual patient s inherent sensitivity to these tissue concentrationsAlthough neonatal peripheral tissue compartments for gentamicin have been reported to closely resemble those of adults with similar renal function, gentamicin is rarely nephrotoxic in infants. This dissimilarity in the incidence of nephrotoxicity implies that newborn infants may have less inherent tissue sensitivity for toxicity than adults. 

Routine use of dexamethasone in meningitis is not without controversy. A potential concern is that adjunctive dexamethasone therapy might reduce the penetration of antibiotics into the CSF by inhibiting meningeal inflammation. In experimental models of meningitis, steroids decreased the CSF concentrations of ampiciUin, rifampin, vancomycin, and gentamicin. Ceftriaxone penetration into CSF was unaffected by concurrent dexamethasone administration in pediatric patients. ... 

Vancomycin hydrochlo- Pediatric dose penicillin 200,000 units/kg per 24 hours IV in tour to six equally divided doses ceftriaxone 100 mg/kg per 24 hours IV/IM in one dose gentamicin 3 mtf kg per 24 hours IV/IM in one dose or three equally divided doses 30 m kg per 24 hours IV in two equally divided doses not to exceed 2 4 IB (second option to single daily dose) Vancomycin therapy recommended only for patients unable to tolerate... 

Parry MF, Neu HC, Merlino M, et al. Treatment of pulmonary infections in patients with cystic fibrosis A comparative study of ticarcillin and gentamicin. J Pediatr 1977 90 144-148. 

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