Clinical Study of the Use of the New Aminoglycoside Tobramycin for Therapy of Infections Due to Gram-Negative Bacteria

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The pharmacokinetics of tobramycin were studied in five patients with stable renal impairment, four patients requiring peritoneal dialysis, and four patients on chronic hemodialysis. The half-life of the drug varied with the level of the serum creatinine in the first group of patients, and the average volume of distribution was 15 liters. Only 49% of the administered dose of tobramycin was recovered during 36 h of peritoneal dialysis. The average clearance of tobramycin during hemodialysis was 49.1 ml/min, and 51.5% of the administered dose was recovered during a 6-h dialysis.

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confidence: 99%

Pharmacokinetics of Tobramycin in Patients with Stable Renal Impairment, Patients Undergoing Peritoneal Dialysis, and Patients on Chronic Hemodialysis

Jaffé

Meyers

Hirschman

1974

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“…The evaluation of tobramycin in patients with P. aeruginosa VOL. 8,1975 25 on (4,10). Most gentamicin toxicity has been associated with serum levels of 8 to 12 ,ug/ml or higher (5,17).…”

Section: Discussionmentioning

confidence: 99%

“…Tobramycin has been shown to be effective in the treatment of urinary tract infection, septicemia, and pneumonia due to various gram-negative bacilli (8,9,18). The evaluation of tobramycin in patients with P. aeruginosa VOL.…”

Section: Discussionmentioning

confidence: 99%

“…For most strains of Pseudomonas, the minimal inhibitory concentrations (MIC) of tobramycin frequently have been slightly less than that of gentamicin (2,3,11,13,19). However, few data on the clinical efficacy of tobramycin have yet been published (8,9). We have investigated the efficacy of tobramycin in 25 hospitalized patients with serious infections caused by P. aeruginosa.…”

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confidence: 99%

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Therapy of Pseudomonas aeruginosa Infections with Tobramycin

Blair

Fekety²,

Bruce³

et al. 1975

The efficacy of tobramycin in doses of 2.7 to 5.6 mg/kg per day in 29 courses of therapy in 25 hospitalized patients with serious Pseudomonas aeruginosa infections was studied. Eighty-three percent of the P. aeruginosa strains showed zones of inhibition of 16 mm or more around a 10-μg tobramycin disk in the Bauer-Kirby disk method. Tobramycin minimal inhibitory concentration ranged from <0.05 to 1.5 μg/ml (microtiter twofold dilution method); for gentamicin they ranged from 0.05 to 6.2 μg/ml; corresponding geometric means were 0.19 and 0.49 μg/ml. Therapy was given for a median of 10 days (mean 19, range 1 to 83). The clinically satisfactory response rate for the 29 courses of therapy was 52%: critically ill, 44%; seriously ill, 50%; moderately ill, 80%. The response rates for various sites of infection were bone and cartilage, 100%; urinary tract infection, 56%; wound, 50%; respiratory tract, 67%; septicemia, 40%; abscess, 0%; burns, 44%. No adverse reactions were seen. Serum concentration (μg/ml ± standard deviation) of tobramycin determined by an agar-well plate method, were 4.81 ± 2.17 (1 h); 3.24 ± 1.43 (2 h); 2.35 ± 1.30 (4 h); and 1.40 ± 1.09 (8 h). Tobramycin appears to be as effacacious as gentamicin in the treatment of serious P. aeruginosa infections and has a theoretical advantage of lower minimal inhibitory concentration for P. aeruginosa . The data suggest that, for life-threatening infections, dosages of tobramycin may need to be increased over those used in this study.

“…Tobramycin, an aminoglycoside antibiotic, has been found to be highly active against P. aeruginosa (1,5,15,16). On a weight basis it is frequently two to four times more active than gentamicin against clinical isolates of P. aeruginosa.…”

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confidence: 99%

Susceptibility of Pseudomonas aeruginosa to Tobramycin or Gentamicin Alone and Combined with Carbenicillin

1976

aeruginosa was investigated. One hundred and ninety-nine were obtained from the clinical bacteriology laboratory of the Medical University of South Carolina (through the cooperation of E. R. Bannister) where they had been isolated from pus, urine, or blood. Sixty-three were isolated at Emory University Hospital, Atlanta, Ga., and kindly provided by J. A. Shulman. Two tobramycin-resistant strains were supplied by Eli Lilly and Co.Antibiotic susceptibility testing. All strains were tested for susceptibility to carbenicillin, gentamicin, and tobramycin and to combinations of gentamicin plus carbenicillin and tobramycin plus carbenicillin, using a two-dimensional agar dilution method on Mueller-Hinton agar (Difco Laboratories). An inoculum of approximately 5 x 10' organisms was delivered onto the agar surface from an overnight culture in Trypticase soy broth using the inocula replicating