ESPU Congress 2018 - Abstract Book

167 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