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11–14 APRIL, 2018, HELSINKI, FINLAND
09:16–09:19
S22-3 (PP)
SAFETY AND EFFICACY OF INTRAVESICAL GENTAMICIN
THERAPY IN PAEDIATRIC PATIENTS WITH COMPLEX
UROLOGICAL CONDITIONS
David KEENE, Beverley WHITNALL and Liz EDWARDS
Royal Manchester Children's Hospital, Department of Paediatric Urology, Manchester, UNITED KINGDOM
PURPOSE
Intra-vesical gentamicin therapy (IGT) has been used in adult cystitis patients and paediatric pa-
tients with complex urological conditions (Defoor, J.Urol.2006;175(5):1861–4). The authors aimed
to compare the safety and efficacy data with published literature.
MATERIAL AND METHODS
A prospective study was performed in a single institution between 2016 and 2017. A treatment
course was twice a day for 7 days. A prophylactic course was 3 times a week for up to 6 months.
Gentamicin 40 mg was added to 100 mls urotainer and instilled into an empty bladder by gravity
over 5 minutes. The bladder was emptied after 1 hour. Gentamicin levels were performed 1 hour
after the IGT on days 1, 3 and 7. Chi-squared test was used to compare the outcomes (elevated
gentamicin level and breakthrough UTI) between this cohort and published literature.
RESULTS
17 patients were commenced on IGT for recurrent urinary tract infections (10 treatment courses
for current symptomatic UTIs and 11 prophylactic courses). Underlying conditions included neuro-
pathic bladder (6), bladder exstrophy (4), posterior urethral valves (3), cloacal anomaly (1), revision
pyeloplasty (1), severe overactive bladder (1). 4 patients stopped IGT early (2 breakthrough UTIs,
1 developed diarrhoea, 1 gentamicin resistance).
Current study
Defoor 2006
P value
(Chi-squared test)
Number of patients (Male:Female)
17 (9M: 8F)
80 (38M: 42F)
Median age (years)
4.2 (0.7-10.7)
10 (0.3-36)
Median duration (days)
51 (7-227)
90
Indwelling or SP catheter
6 (35 %)
11 (14 %)
Elevated gentamicin levels > 0.4 mg/dL 0 %
0 %
Breakthrough UTI
4 (24 %)
21 (26 %)
0.82
Gentamicin resistance
1 (6 %)
5 (6 %)
0.95
CONCLUSIONS
There was no difference in the safety or efficacy of intra-vesical gentamicin therapy between the
current study and published literature (Defoor 2006). Intra-vesical gentamicin therapy is a safe
feasible option in children with recurrent urinary tract infections and complex urological conditions.
09:19–09:28
Discussion