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Related Experiment Videos

Tobramycin-induced hepatotoxicity.

Sarah A Nisly1, Shaunta' M Ray, Robert A Moye

  • 1College of Pharmacy and Health Sciences, Butler University, Indianapolis, IN, USA.

The Annals of Pharmacotherapy
|October 25, 2007
PubMed
Summary
This summary is machine-generated.

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This case report suggests tobramycin may cause liver damage (hepatotoxicity). Liver enzymes elevated during tobramycin treatment and improved after discontinuation, indicating a probable link.

Area of Science:

  • Pharmacology
  • Hepatology
  • Infectious Diseases

Background:

  • Aminoglycosides, including tobramycin, are crucial for treating severe bacterial infections.
  • Drug-induced liver injury (DILI) is a significant concern in clinical practice.
  • Pseudomonas aeruginosa infections often require potent antibiotic regimens.

Observation:

  • A 20-year-old female developed elevated liver enzymes during treatment for Pseudomonas aeruginosa bacteremia and osteomyelitis.
  • The patient received intravenous ceftazidime and tobramycin, with liver enzyme levels rising after tobramycin initiation and dose escalation.
  • Hepatitis and HIV were ruled out; other concurrent medications were reassessed.

Findings:

  • Liver enzyme levels (total bilirubin, AST, ALT, alkaline phosphatase) normalized after tobramycin discontinuation.

Related Experiment Videos

  • Causality assessment scales (Naranjo, CIOMS, Maria and Victorino) indicated a probable relationship between tobramycin and hepatotoxicity.
  • No rechallenge was performed due to the clear temporal association and patient risk.

    • Implications:

    • This case highlights a potential, though rare, adverse effect of tobramycin: drug-induced liver injury.
    • Clinicians should monitor liver function in patients receiving tobramycin, especially at higher doses or for prolonged periods.
    • Further research may be warranted to fully elucidate the incidence and mechanisms of tobramycin-induced hepatotoxicity.