665 Timely Gentamicin Sampling and Impacts on Administration in Paediatric Surgical Patients

Aim Gentamicin serum level monitoring is mandatory to ensure safe administration. Optimum guidance in children suggests an 18–23-hour sampling window following the 1st dose. We aim to see if this target is met and to improve timely administration of gentamicin in a paediatric surgery department. Method A 6-week retrospective review included paediatric surgical patients receiving once daily gentamicin in our hospital. Data collected included times of blood sampling, receipt by laboratory, result reporting and gentamicin administration. Interventions were then implemented to encourage sampling at 18 hours; including posters, educational sessions, department emails and involvement of nursing, pharmacy, and laboratory teams. Data was then collected prospectively in the same format for comparison. Results Our population included 27 patients: 17 pre-interventions, 10 post. Ages ranged between 1-18 years. Primary indications for gentamicin included appendicitis and anorectal surgery. Pre-intervention, 8/17 (47%) patients had samples taken within 18-23 hours. 3/17 (18%) patients received infusions on time; defined as <1hr due (mean administration 3hr 56m late). Post-intervention, 10/10 (100%) patients were sampled before 23 hours (mean sampling 18hr 35m post-dose). 8/10 (80%) patients received infusions on time (mean administration 4m early). In addition, delays in serum level reports dropped from 76% (pre-intervention) to 10% (post). Conclusions Junior doctor and nursing education led to significant reduction in sampling and administration delays. Setbacks such as laboratory errors or insufficient samples are often accounted for when sampling at 18 hours post-dose. This mindset can be adopted through simple interventions. Of note, no serum levels met the toxicity threshold.