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Acute renal failure associated with inhaled tobramycin
Carrie A Cannella1, Samaneh T Wilkinson
1Department of Pharmacy, The University of Kansas Hospital, Kansas City, 66160, USA. ccannella@kumc.edu
Summary
This case study highlights potential tobramycin inhalation toxicity. An extended course of inhaled tobramycin led to acute renal failure and dialysis in a patient with pre-existing chronic kidney disease.
Area of Science:
- Nephrology
- Pulmonology
- Infectious Diseases
Background:
- A patient with chronic renal insufficiency and sepsis was treated for Pseudomonas aeruginosa pneumonia.
- The patient had a history of multiple comorbidities, impacting renal function.
Observation:
- Inhaled tobramycin was administered for four weeks to treat recurrent pneumonia.
- Serum creatinine levels steadily increased during inhaled tobramycin therapy, from 2 mg/dL to a peak of 4.5 mg/dL.
Findings:
- The patient developed acute renal failure requiring hemodialysis.
- Renal function did not recover to baseline after discontinuation of inhaled tobramycin.
Implications:
- This case suggests a potential risk of nephrotoxicity with prolonged inhaled tobramycin use, particularly in high-risk patients.
- Careful monitoring of renal function is crucial during extended courses of inhaled antibiotics.
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