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Tobramycin absorption from the peritoneal cavity.

J Rubin1

  • 1Department of Medicine, University of Mississippi Medical Center, Jackson.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|January 1, 1990
PubMed
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Peritonitis significantly increases tobramycin absorption from the peritoneal cavity. This rapid uptake, especially with prolonged exposure, may lead to dangerously high serum tobramycin concentrations.

Area of Science:

  • Nephrology
  • Pharmacokinetics
  • Infectious Diseases

Background:

  • Previous research indicated high serum tobramycin levels (>8 mg/L) in peritonitis patients receiving hourly dialysate exchanges with 10 mg/L tobramycin.
  • Understanding tobramycin absorption dynamics is crucial for safe and effective treatment of peritonitis in patients undergoing peritoneal dialysis.

Purpose of the Study:

  • To evaluate tobramycin absorption from the peritoneal cavity in patients with peritonitis using longer (180 min) intraperitoneal dwell times.
  • To compare tobramycin mass transfer coefficients (MTC) between noninfected and peritonitis states.

Main Methods:

  • Six patients were studied in each group (noninfected and peritonitis).
  • Tobramycin absorption was assessed by calculating mass transfer coefficients (MTC) in mL/min.

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  • MTC was determined for both noninfected (C) and peritonitis (P) periods during the study.

    • Main Results:

    • The mean MTC was significantly higher during peritonitis (18.5 ± 8.2 mL/min) compared to the noninfected state (6.5 ± 2.1 mL/min) (p < 0.01).
    • Peritonitis markedly increased the rate of tobramycin uptake from the peritoneal cavity.
    • Despite increased absorption, serum tobramycin concentrations remained low (<0.2 mg/L in controls, <0.5 mg/L in peritonitis patients) in these acute, short-term studies.

    Conclusions:

    • Peritonitis accelerates tobramycin absorption from the peritoneal cavity.
    • Prolonged exposure to tobramycin, combined with enhanced absorption during peritonitis, poses a risk for achieving potentially toxic serum concentrations (>8 mg/L).