Herberger Sarah, Oberkircher Nadine, Wenzel Gentiana I, Hecker Dietmar, Wagenpfeil Gudrun, Furtwängler Rhoikos, Becker Sören L, Papan Cihan, Graf Norbert, Simon Arne
Pediatric Oncology and Hematology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany.
Otorhinolaryngology, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany.
Klin Padiatr. 2021 May;233(3):123-126. doi: 10.1055/a-1352-5053. Epub 2021 Feb 18.
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 BSA (max. 10 mg/kg, max. 400 mg) as a single daily infusion according to the German guideline.
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.
Adherence to the dosing regimen was high (89%). In 64% of all cycles, the C (drawn 1 h after the 2 dose) reached the target of 10-20 µg/ml. C significantly correlated with dosing in mg/m 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 (drawn 8-10 h after the second dose) was < 2 µg/ml in 93% of all cycles without any dose correlation. None of the patients experienced Gentamicin-associated nephrotoxicity.
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 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.
许多儿科癌症中心仍将庆大霉素作为发热性中性粒细胞减少症患者的一线联合治疗药物。自2011年以来，我们中心根据德国指南实施了一种给药方案，即按体表面积250mg/m²（最大10mg/kg，最大400mg）每日单次输注。
在这项前瞻性审计（2011年2月至2019年12月）中，对66例儿科癌症患者的105个庆大霉素治疗周期进行了分析，重点关注给药方案的依从性和药物监测结果。
给药方案的依从性很高（89%）。在所有周期的64%中，C（第二剂后1小时采血）达到了10 - 20μg/ml的目标。C与按体表面积mg/m²给药显著相关（p = 0.007），但与按mg/kg给药无关（p = 0.366）。6岁以下年龄不影响这些结果。在所有周期的93%中，庆大霉素C（第二剂后8 - 10小时采血）<2μg/ml，且与剂量无相关性。没有患者发生庆大霉素相关的肾毒性。
这项对肾功能未受损的儿科癌症患者每日单次输注庆大霉素的前瞻性审计表明，根据德国指南按体表面积mg/m²给药方案具有可行性和安全性。由于一线使用庆大霉素的适应症有限，多中心前瞻性研究将有助于证实这些观察结果。
