Abstract
The efficacy of chemotherapy in treating acute exacerbations of chronic respiratory infections in patients with cystic fibrosis (CF) is sometimes poor. This cannot always be adequately explained by the severity of the disease or the susceptibility of the bacterial flora to the drugs used. After 10 days of treatment+, pulmonary function did not improve in 16 patients with CF, despite tobramycin-sensitive micro-organisms and adequate 1-hour peak (between 5-8 mg/l) and safe 8-hour trough (< 2 mg/1) serum tobramycin concentrations. It appeared that in these patients an 1 mg/l serum tobramycin level was attained within 3-6 hours after a dose. In order to ensure sufficiently protracted serum concentrations which may be expected therapeutically active, in 9 out of the 16 patients, we adjusted the dosing interval to a minimum trough level of 1 mg/l. In the other 7 patients, no alteration in the dosing interval was made. In the patients in whom the dosing interval was shortened, pulmonary function was significantly more improved than in the patients in whom the dosing interval was unchanged (P < 0,02). Toxic side effects of tobramycin were not observed. It is concluded that the use of more frequent dosages of tobramycin may be necessary in treatment of patients with CF. + Tobramycin: 10 mg/kg/day in three divided doses at 8-hr intervals; Ticarcillin: 600 mg/kg/day.
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Horrevorts, A., Driessen, O., de Witte, J. et al. 80 DOSING OF TOBRAMYCIN IN CHILDREN WITH CYSTIC FIBKOSIS USING SERUM CONCENTRATIONS: II. PHARMACODYNAMICS. Pediatr Res 20, 1046 (1986). https://doi.org/10.1203/00006450-198610000-00134
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DOI: https://doi.org/10.1203/00006450-198610000-00134