Fifty children aged 3 months--16 y with Gram-negative bacterial infections, were evaluated in this open randomized study; 26 received gentamicin 4.5 mg/kg/day, once daily, and 24 received the same daily dosage, in three divided doses. The groups had similar demographic and clinical characteristics. Serum trough gentamicin concentrations were significantly lower in the od group than in the tds group, while peak concentration were significantly higher in the od group. Clinical cure was obtained in 23 of the 26 (88.8%) children who received gentamicin once daily, and in 22/24 (91%) children treated thrice daily. Microbiological cure was obtained in 10/10 (100%) and 12/13 (92%) of the evaluated cases. Nephrotoxicity was not observed but ototoxicity occurred in two children in each group. These results, although obtained from a small number of patients, showed a similar outcome in children receiving gentamicin 4.5 mg/kg/day whether administered once or thrice daily.
These data support the notion that testicular hypotrophy related to varicocele may be reversed by early intervention and they further strengthen the indication for varicocelectomy in children.
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