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Can tobramycin inhalation be improved with a jet nebulizer?
P P Le Brun1, A A Vinks, D J Touw
1Central Hospital Pharmacy The Hague, The Netherlands.
Therapeutic Drug Monitoring
|December 22, 1999
Summary
This pilot study assessed tobramycin pharmacokinetics after inhalation, finding significant interpatient variability. However, low serum levels suggest potential for dose escalation in treating lung infections.
Area of Science:
- Pharmacology
- Pulmonary Medicine
- Infectious Diseases
Background:
- Limited data exists on antibiotic pharmacokinetics following inhalation.
- Inhaled antibiotics are a potential treatment for lung exacerbations.
Purpose of the Study:
- To assess tobramycin pharmacokinetics under standardized aerosol conditions.
- To evaluate the feasibility of inhaled tobramycin for treating exacerbations.
Main Methods:
- Six patients inhaled 600 mg of tobramycin using a jet nebulizer.
- Serum tobramycin levels were monitored.
- Pharmacokinetic data were analyzed using a two-compartment model.
Main Results:
- Systemic absorption ranged from 1.0% to 16.6%.
- Mean peak serum tobramycin levels were 1.70 +/- 1.01 mg/L.
- A long terminal half-life (mean 9.47 h) indicated slow absorption (flip-flop model).
- Considerable interpatient variability was observed.
Conclusions:
- Inhaled tobramycin exhibits slow absorption and significant interpatient variability.
- Observed low serum levels support exploring higher doses for effective treatment.
- Further research into inhaled tobramycin dosing is warranted.