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Controlled release infusion kinetics of tobramycin
J R Lane1, W E Murray, N L Willenborg
1Department of Clinical Pharmacy, UCSD Medical Center 92103.
Therapeutic Drug Monitoring
|January 1, 1989
Summary
The CRIS infusion system delivered significantly more tobramycin (98.3%) than intravenous piggyback (IVPB) infusion (90.4%). This led to higher peak serum tobramycin levels and faster attainment in healthy male volunteers.
Area of Science:
- Pharmacokinetics and Drug Delivery
Background:
- Intravenous drug administration methods can influence drug delivery efficiency and patient outcomes.
- Tobramycin is an antibiotic requiring precise dosing to maintain therapeutic efficacy and minimize toxicity.
Purpose of the Study:
- To compare the drug delivery efficiency of the CRIS infusion system versus traditional intravenous piggyback (IVPB) for tobramycin.
- To evaluate the impact of different infusion methods on tobramycin serum concentration profiles and urinary recovery.
Main Methods:
- A crossover study involving ten healthy male volunteers receiving tobramycin (2 mg/kg) via IVPB and CRIS systems.
- Serum and 24-hour urine samples were collected and assayed for tobramycin concentration using an enzyme-multiplied immunoassay technique.
- Residual drug in infusion lines was measured to determine actual delivered dose for each method.
Main Results:
- The CRIS system demonstrated statistically higher drug delivery efficiency (98.3% ± 0.3%) compared to IVPB (90.4% ± 2.3%).
- CRIS infusion resulted in significantly higher peak serum tobramycin levels, with 80% of subjects exceeding 10 µg/ml, versus 0% for IVPB.
- Peak serum levels were achieved faster with CRIS (30 min) compared to IVPB (50-60 min); no significant difference in urinary recovery was observed.
Conclusions:
- The CRIS infusion system provides more accurate and efficient delivery of tobramycin compared to IVPB.
- Differences in drug delivery rates and total dose administered significantly impact tobramycin's pharmacokinetic profile, particularly peak serum concentrations.
- Optimized drug delivery systems like CRIS may be crucial for achieving desired therapeutic targets and improving patient outcomes in tobramycin therapy.