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Tobramycin absorption from the peritoneal cavity
1Department of Medicine, University of Mississippi Medical Center, Jackson.
Abstract:
Previous studies have found serum tobramycin concentrations greater than 8 mg/L among patients undergoing treatment for peritonitis using hourly dialysate exchanges containing 10 mg/L of tobramycin. In this study, tobramycin absorption from the peritoneal cavity was evaluated among patients treated with exchanges of 180 min. intraperitoneal duration. Six patients in each group were studied. Mass transfer coefficients [MTC (mL/min.)] were calculated for noninfected (C) and peritonitis (P) periods. The mean MTC for C was 6.5 +/- 2.1 (SD) mL/min., and for P, 18.5 +/- 8.2 (SD) mL/min. (p less than 0.01). Peritonitis increased the rate of uptake from the peritoneal cavity. In these acute studies, the total dose of tobramycin delivered was small, so that serum concentrations remained less than 0.2 mg/L among controls and 0.5 mg/L among patients with peritonitis. Prolonged exposure to tobramycin, in association with more rapid absorption from the peritoneal cavity, may lead to serum concentrations greater than 8 mg/L.
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