Serum Levels of Gentamicin and Tobramycin After Slow Intravenous Bolus Injection

Stratford, Bryan C.; Dixson, Shirley; Cobcroft, A.J.

doi:10.1016/s0140-6736(74)93148-1

Cited by 37 publications

(7 citation statements)

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“…With the same large dose of kanamycin and amikacin, capsular fluid concentrations of amikacin were slightly higher (Table 2), although this was not significant statistically. Gentamicin and tobramycin also have similar pharmacokinetics (16,27). Serum and capsular peak concentrations were similar for the two drugs (Table 2).…”

Section: Discussionmentioning

confidence: 80%

Cephalosporin and Aminoglycoside Concentrations in Peritoneal Capsular Fluid in Rabbits

Gerding

Hall

Schierl

et al. 1976

Antimicrob Agents Chemother

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To study the penetration of antibiotics into peritoneal tissue fluid, a subcutaneous tissue capsule model was modified by implanting multiple, perforated spherical capsules in the peritoneal cavity ofrabbits. Capsules became vascularized, encased in connective tissue, and filled with fluid having a mean protein concentration of 3.6 g/100 ml. Capsular fluid was obtained by percutaneous needle aspiration and assayed for antibiotic by the disk plate bioassay technique. Cephalosporins were administered intramuscularly at a dose of30 mg/kg. Mean peak concentrations of cephaloridine and cefazolin were significantly higher than cephalothin and cephapirin in capsular fluids, but the percent penetration (ratio of capsular mean peak to serum mean peak) ranged from 8.7 to 16.9% and was not significantly different among the cephalosporins. At 24 h the capsular concentration of cefazolin was significantly greater than for the other cephalosporins (P < 0.001). Lower rabbit serum protein binding observed at high in vivo concentrations may have enabled cefazolin to penetrate capsular fluid, but in vitro protein binding studies did not confirm a decrease in serum protein binding at high concentrations within the clinical range. Kanamycin and amikacin showed comparable capsular fluid peak concentrations as did gentamicin and tobramycin. The percent penetration ranged from 15.2 to 34.5% for the aminoglycosides. The only statistical difference was that amikacin penetration was significantly higher than that for tobramycin. Mean capsular concentrations of amikacin, cefazolin, and cephaloridine compared most favorably with the minimum inhibitory concentration of gram-negative bacilli at the dosages used in this study.

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Section: Discussionmentioning

confidence: 80%

Cephalosporin and Aminoglycoside Concentrations in Peritoneal Capsular Fluid in Rabbits

Gerding

Hall

Schierl

et al. 1976

Antimicrob Agents Chemother

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“…Quick intravenous bolus injections should be avoided since, after 1 mg intravenously of gentamicin or tobramycin per kg, the concentration may surpass the toxicity limit of 12.5 to 15.0 /sg/ml for a short period, as recently shown by Stratford et al (22). On the basis of these reports and upon consideration of the 1.3 times higher vestibular toxicity of sisomicin (26), the relatively low dose of 1 mg/kg of body weight was selected and infused for 1 h. Regarding pharmacokinetic data for the individual aminoglycosides, the results obtained for gentamicin correspond entirely to those from previous studies of Black et al (1), and Jao and Jackson (8), Winters et al (29), as well as those of Naumann and Auwiirter (17).…”

Section: Resultsmentioning

confidence: 99%

Comparative Clinical Pharmacology of Gentamicin, Sisomicin, and Tobramycin

Lode

Kemmerich

Koeppe

1975

Antimicrob Agents Chemother

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Using a randomized crossover design involving 12 normal subjects, we studied comparatively the pharmacokinetics and tolerance of three aminoglycoside antibiotics, gentamicin, sisomicin, and tobramycin. Serum concentrations were determined during 8 h and the urine recovery rate was determined within 24 h after a 1-h intravenous infusion of the respective antibiotic in a dose of 1 mg/kg of body weight. Microbiological assay was performed with the agar diffusion test (Bacillus subtilis); pharmacokinetic calculations were performed by means of a digital computer on the basis of a mathematical model of an open, two-compartment system. Of the three antibiotics studied, gentamicin showed the lowest concentration in serum after termination of the 1-h infusion (3.85 i 0.67 yg/ml), and the serum-regression curve steadily lay below those of the two other antibiotics. Sisomicin had the highest serum concentrations (4,66 i 1.24,ug/ml) and the serum-level curve exceeded that of the two other antibiotics. Tobramycin occupied a position between sisomicin and gentamicin in form of its serum level characteristics. Corresponding to the serum kinetics we also found slight differences in the pharmacokinetic parameters, especially in serum half-lives, elimination constants, and areas under the serum level curves.

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“…67 In addition to the studies cited in Table 1, gentamicin has reportedly been administered over time periods ranging from <10 seconds to 5 minutes, [89][90][91][93][94][95][96] while tobramycin has been administered over time periods ranging from 15 seconds to 5 minutes. 89,90,[96][97][98][99][100][101] Most administration times for gentamicin and tobramycin ranged from approximately 3 to 5 minutes. These studies were of varying quality and instructions for preparation were not described.…”

Section: Aminoglycosidesmentioning

confidence: 99%

Intravenous Push Administration of Antibiotics: Literature and Considerations

et al. 2018

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Intravenous (IV) push administration can provide clinical and practical advantages over longer IV infusions in multiple clinical scenarios, including in the emergency department, in fluid-restricted patients, and when supplies of diluents are limited. In these settings, conversion to IV push administration may provide a solution. This review compiles available data on IV push administration of antibiotics in adults, including preparation, stability, and administration instructions. Prescribing information, multiple tertiary drug resources, and primary literature were consulted to compile relevant data. Several antibiotics are Food and Drug Administration-approved for IV push administration, including many beta-lactams. In addition, cefepime, ceftriaxone, ertapenem, gentamicin, and tobramycin have primary literature data to support IV push administration. While amikacin, ciprofloxacin, imipenem/cilastatin, and metronidazole have limited primary literature data on IV push administration, available data do not support that route. In addition, a discussion on practical considerations, such as IV push best practices and pharmacodynamic considerations, is provided.

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Serum Levels of Gentamicin and Tobramycin After Slow Intravenous Bolus Injection

Cited by 37 publications

References 1 publication

Cephalosporin and Aminoglycoside Concentrations in Peritoneal Capsular Fluid in Rabbits

Cephalosporin and Aminoglycoside Concentrations in Peritoneal Capsular Fluid in Rabbits

Comparative Clinical Pharmacology of Gentamicin, Sisomicin, and Tobramycin

Intravenous Push Administration of Antibiotics: Literature and Considerations

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