Tobramycin in Pediatric Use

Raine, P.A.M.; Young, D. G.; McAllister, Tim A.; Tait, Susan C.

doi:10.1093/infdis/134.supplement_1.s165

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…Tobramycin as a therapeutic drug in human gram-negative bacillary meningitis has been tested by Kaiser and McGee [9] and Raine et al [17], Clinical responses of meningitis to single and combination tobra mycin therapy have been evaluated by Bendush and Weber [4]. Ventricular, cisternal and lumbar CSF levels of tobramycin administered by the 1. v. route did not exceed 1.0 /tg/ml.…”

Section: Discussionmentioning

confidence: 99%

“…This aminoglycoside antibiotic is most frequently used in treatment of neonatal meningitis and bacillary meningitis due to enteric bacil li [1,10,15,16,18,21,23]. Investigations about CSF levels of tobramycin found to be the aminoglycoside antibiotic with higher activity against pseudomonas strains [7,24] and statistically significant lower nephrotox icity than gentamicin [20] have rarely been performed in humans [9,17] and animals [3,19,22]. To get a better knowledge about CSF contents of this drug in varying degrees of impairment of the blood-CSF barrier, this investigation was initiated in patients on i.m./ i.v.…”

mentioning

confidence: 99%

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Tobramycin Levels in Cerebrospinal Fluid of Patients with Slightly and Severely Impaired Blood-Cerebrospinal Barrier

Brückner¹,

Alexander²,

Collmann³

1981

Chemotherapy

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Concentrations of tobramycin in cerebrospinal fluid (CSF) and serum of neurosurgical and of meningitis patients were determined following systemic application of 80-mg doses. Tobramycin was detectable only in 8 tests out of 17 in CSF of 11 neurosurgical patients. The highest drug amount in CSF in these tests was 0.47 µg/ml. In CSF of 7 meningitis patients with CSF cell counts ranging from 173/3 to 20,500/3 cells, tobramycin was detectable in all 11 determinations. However, the tobramycin level was above 1.0 µg/ml in only one CSF sample. These results also confirm the poor penetrability of aminoglycosides through the blood-CSF barrier for tobramycin. In proven gram-negative bacillary meningitis and tobramycin treatment, additional intraventricular aminoglycoside application is necessary to obtain effective levels in CSF. An exception may be treatment of neonatal meningitis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Tobramycin Levels in Cerebrospinal Fluid of Patients with Slightly and Severely Impaired Blood-Cerebrospinal Barrier

Brückner¹,

Alexander²,

Collmann³

1981

Chemotherapy

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“…However, one third of these studies did not report which concomitant antibacterial agents were used. In 11 % of the studies, it was specified that the intraperitoneal antibacterial agent was the only drug administered [40,42,47,61,63,77,81,90,95,96], and 20 % of the studies lacked a description on whether other antibacterial agents had been administered [3,25,26,37,43,46,54,66,72,73,82,83,88,89,93,98,99].…”

Section: Other Resultsmentioning

confidence: 99%

Characterisation and Safety of Intraperitoneal Perioperative Administration of Antibacterial Agents: A Systematic Review

et al. 2017

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Intraperitoneal drug administration applies treatment at the site of diseases with gynaecological, urological, or gastrointestinal origin. The objective of this systematic review was to investigate perioperative intraperitoneal administration of antibacterial agents to characterise the drugs used and their safety profile. A protocol was registered at PROSPERO (CRD42016038956). A systematic review was conducted and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A search was performed in PubMed and EMBASE on the 22 of April 2016. The inclusion criteria were original articles involving at least 5 patients where antibacterial agents were administered intraperitoneally during or after abdominal surgery as prophylaxis or treatment of infection. Languages were limited to English, German, Danish, Norwegian, or Swedish articles. 79 studies were included which used a total of 12 different antibacterial classes. Aminoglycosides, 1 and 2 generation cephalosporins, tetracyclines, and penicillins were most commonly administered intraperitoneally during or after surgery. The antibacterial agent was usually administered intraperitoneally as monotherapy. However, some studies administered combination regimens with heparin or with another antibacterial agent. The most frequent combination was aminoglycosides and lincosamides. In total, 43% of studies lacked information regarding adverse events. The most frequently reported adverse event was discomfort or pain during administration, especially with use of oxytetracycline. At least 12 different classes of antibacterial agents have been administered intraperitoneally during or after surgery as prophylaxis or treatment of intraabdominal infections. Intraperitoneal administration seems safe although use of oxytetracycline may cause discomfort or pain.

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“…Raine et al [22] administered tobramycin intramuscularly, intravenously, and intraperitoneally at a dose of 5 mg/kg daily to 38 infants and children who were infected by gram-negative organisms and staphylococcal species. Microorganisms were eradicated by tobramycin and serum concentrations ranged from 2 to 10 µg/ml.…”

Section: Tobramycin Is a Safe Antibiotic And Induces Only Limited Toxmentioning

confidence: 99%

Clinical pharmacology of tobramycin in infants and children

Pacifici¹

2020

Clin Med Invest

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Tobramycin is an aminoglycoside antibiotic, binds to polysomes and interferes with bacterial protein synthesis causing misreading and premature termination of mRNA translation, it is bactericidal, has post-antibiotic effect on bacterial killing, and antimicrobial effect is concentration-dependent. This antibiotic may be administered orally, intravenously (either by slow injection or intravenous infusion), intramuscularly, applied to skin, and lung infections may be treated by inhalation. Tobramycin intravenous doses are: 5 mg/kg every 36 hours in infants, with a postmenstrual age < 32, and once-daily in older infants, and in children, doses are 2.5 and 3.5 mg/kg thrice-daily. Tobramycin effects are: increase of sodium excretion in the urine, tubular injury, and bronchoconstriction. This antibiotic well diffuses through all body organs, including the central nervous system, and successfully treated lung, kidney, ear, mouth, throat, eye, skin infections, rhinopharyngitis, and meningitis. Tobramycin peak and trough concentrations should be > 10 and < 2 µg/ml, respectively, in order to yield antimicrobial effect and to keep toxicity low. Optimization of treatment has been recommended in order to keep serum concentrations within the therapeutic-interval as they vary in infants and children. Tobramycin half-life is longer in infants (about 10 hours) than in children. Some organisms may become resistant to tobramycin. The aim of this study is to review published data on tobramycin dosing, efficacy, safety, effects, adverse-effects, drug-interactions, treatment optimization, trials, meningitis, pharmacodynamics, pharmacokinetics, and bacterial-resistance in infants and children.

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Tobramycin in Pediatric Use

Cited by 8 publications

References 9 publications

Tobramycin Levels in Cerebrospinal Fluid of Patients with Slightly and Severely Impaired Blood-Cerebrospinal Barrier

Tobramycin Levels in Cerebrospinal Fluid of Patients with Slightly and Severely Impaired Blood-Cerebrospinal Barrier

Characterisation and Safety of Intraperitoneal Perioperative Administration of Antibacterial Agents: A Systematic Review

Clinical pharmacology of tobramycin in infants and children

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