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Journal of Antimicrobial Chemotherapy (2000) 45, 383-386
© 2000 The British Society for Antimicrobial Chemotherapy

Brief reports

Once-daily versus multiple-daily gentamicin in empirical antibiotic therapy of febrile neutropenia following intensive chemotherapy

Fatima El Bakria,*, A. Palletta, A. G. Smithb and A. S. Duncombeb

a Department of Medical Microbiology and b Department of Haematology, Southampton University Hospitals NHS Trust, Southampton, UK

The clinical efficacy and toxicity of once-daily compared with multiple-daily gentamicin dosing, in combination with azlocillin, were studied retrospectively in febrile neutropenic episodes following intensive chemotherapy. Fifty-two episodes were studied in 28 patients with acute myeloid leukaemia. Reasons for initiation of antibiotic therapy, dose, duration of treatment, organism isolation rates, response, cost comparison and toxicity were studied in the two treatment groups. The main indication for initiation of antibiotic therapy was neutropenic fever without a documented infection (80.8% of episodes). The response rate to once-daily gentamicin dosing and azlocillin was three times higher than to multiple-daily gentamicin dosing and azlocillin (P = 0.0112). The incidence of toxicity was low overall and was slightly but not significantly higher in the once-daily group. In this clinical context once-daily gentamicin at a dose of 7 mg/kg/day is more effective than a multiple-daily dosing regimen but may be more toxic.

* Correspondence address. Public Health Laboratory, Level B South Laboratory and Pathology Block, Southampton General Hospital, Southampton SO16 6YD, UK. Tel: +44-1703-796-408; Fax: +44-173-702-530.


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