Temperature dependence of the stability of tobramycin mixed with penicillins in human serum

O'Bey, Kimberly A.; Jim, Lucia K.; Gee, Joseph P.; Johnson, Robert M.

doi:10.1093/ajhp/39.6.1005

Cited by 10 publications

(8 citation statements)

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“…Maximum serum values (peak) reported herein, although comparable to those observed by Williams et al, 8 are somewhat lower than those described by Arbeter et al 9 and more recently by Nahata et al 13 The factors previously mentioned may explain some of the differences and also it is likely that handling and storage of the serum samples may have contributed to a significant degradation of the aminoglycoside. 22 The sensitivity, precision, accuracy, and specificity of the homogenous enzyme immunoassay (EMIT®) used in this study seems to be adequate for clinical purposes. 23 In the present study, only an occasional serum concentration exceeded 12 mcg/ml, and it is our opinion that a 2.5-mg/kg dose of tobramycin is in most cases quite sufficient to produce peak concentrations in the therapeutic range.…”

Section: Discussionmentioning

confidence: 86%

“…Technique of infusion, 17 delivery system, 18 and even the size of the intravenous tubing 19 are factors that could certainly affect the magnitude and timing of the highest serum aminoglycoside concentration. In addition, the reported in vitro interaction 22 between aminoglycoside and beta-lactam antibiotics may result in a low peak concentration, especially if these medications are administered concurrently.…”

Section: Discussionmentioning

confidence: 99%

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Serum Tobramycin Levels in Low- and Very Low-Birthweight Infants

Cordero¹,

Arwood²,

Hann³

et al. 1984

Amer J Perinatol

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This study was designed to evaluate the serum concentration of tobramycin sulfate following a 2.5-mg/kg intravenous infusion in 43 premature infants on days 1, 3, and 5 of age (therapy). Twenty premature infants weighing 1500 gm or less at birth and 23 others whose birthweights ranged from 1501 to 2500 gm made up the study population. Serum tobramycin levels were measured by an enzymatic immunoassay (EMIT) at one, four to six, and 12 hours after injection. Peak serum levels increased from day 1 (means, 5.2 +/- 2.2 mcg/ml) to day 3 (means, 6.1 +/- 2.6 mg/ml) and then remained unchanged at day 5 (means, 6.1 +/- 2.4 mg/ml). Approximately 40% of the study population presented trough levels above 2 mcg/ml on day 1 and over 70% on days 3 and 5. No evidence of renal toxicity or auditory dysfunction was observed. In light of the high trough levels observed during the first week of life in premature infants, it may be judicious to monitor serum tobramycin concentration and to decrease the dosage or to prolong the dose interval in order to maintain trough concentrations below 2 mcg/ml.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Serum Tobramycin Levels in Low- and Very Low-Birthweight Infants

Cordero¹,

Arwood²,

Hann³

et al. 1984

Amer J Perinatol

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“…Serum concentrations of netilmicin similarily to other aminoglycosides can be falsely lowered by sample processing, length of storage, and by the presence of a significant amount of ampicillin. 14 Using the four previously mentioned serum levels and a first-order one compartment model, the pharmacokinetic constants were calculated using nonlinear regression analysis of serum concentrations versus time curve. The pharmacokinetic constants calculated for each infant were then used to predict serum concentration had those infants been given a 2 mg/kg dose every 12 hours.…”

Section: Methodsmentioning

confidence: 99%

Serum Netilmicin Levels in Premature AGA Infants

Cordero¹,

Arwood²,

DeCenzo³

et al. 1987

Amer J Perinatol

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Safe use of aminoglycosides requires close monitoring of serum concentrations. Limited information coupled with marked changes in fluid compartments and renal function during the first week of life in premature neonates makes interpretation of peak and trough levels very difficult. This study was designed to measure serum netilmicin levels following a 2.5 mg/kg IV push infusion. Blood samples were taken on the 5th day of therapy 1 hour before and 1, 6, and 11 hours after a dose. Fifteen premature infants weighing 1000-1500 gm at birth and 20 others whose weight ranged from 1501-2750 gm comprised the study population. All premature infants were appropriate for gestational age (AGA) and of them, only two were severely asphyxiated. At the time of the study, 10 neonates were still on respirators. Serum and urine sodium and creatinine, BUN, and urinalysis were obtained in 28 of these infants. No evidence of renal dysfunction was found. All infants received 100 mg/kg IV ampicillin every 12 hours, but none were being treated with diuretics. Serum netilmicin levels were measured by an enzymatic immunoassay, peak and trough were calculated by extrapolating the first order decay curve. Peak levels ranged from 3.4 to 14 micrograms/ml (means 6.1 +/- 2.5 micrograms/ml SD) and 90% of them were above 4 micrograms/ml. Half of the small premature infants (1000-1500 gm birthweight) presented trough values above 3 micrograms/ml. Pharmacokinetic analysis of our data predicts that a 2.5 mg/kg loading dose followed by 2 mg/kg given every 12 hours will decrease by one-half the number of small prematures exceeding the considered "safe" trough level (greater than 3 micrograms/ml).

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“…Aminoglycoside inactivation is dependent on time, temperature, concentration as well as the specific drug involved (O'Bey et al 1982;Pickering & Rutherford 1981;Pieper et al 1980). This interaction has been described most frequently in patients with renal failure who received carbenicillin or ticarcillin combined with gentamicin or tobramycin (Ervin et al 1976;Matzke et al 1984b;Thompson et al 1982).…”

Section: Aminoglycosidesmentioning

confidence: 99%

Clinical Pharmacokinetics of Antibiotics in Patients with Impaired Renal Function

Peter

Redic-Kill

Halstenson

1992

Clinical Pharmacokinetics

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Many antibiotics are eliminated renally and dosage adjustments are commonly made in patients with renal insufficiency. This is a critical review of antibiotic pharmacokinetics in patients with various degrees of renal function. Detailed information regarding pharmacokinetic alterations with specific antibiotics or antibiotic classes has been compiled and tabulated. From pharmacokinetic evidence, recommendations for dosage adjustments of antibiotics are supplied. The criteria used for assigning rating levels to specific pharmacokinetic articles as well as the grading system for dosage adjustments are outlined. In addition, a basic review of pharmacokinetic alterations in renal failure and factors affecting the removal of drugs by haemodialysis is included.

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Temperature dependence of the stability of tobramycin mixed with penicillins in human serum

Cited by 10 publications

References 0 publications

Serum Tobramycin Levels in Low- and Very Low-Birthweight Infants

Serum Tobramycin Levels in Low- and Very Low-Birthweight Infants

Serum Netilmicin Levels in Premature AGA Infants

Clinical Pharmacokinetics of Antibiotics in Patients with Impaired Renal Function

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