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Related Experiment Videos

Tobramycin therapy--two or three doses per day?

H Lilliestierna, K Alestig, S Holm

    Scandinavian Journal of Infectious Diseases
    |January 1, 1985
    PubMed
    Summary

    For moderate infections, twice-daily (BID) tobramycin injections achieved higher serum concentrations than thrice-daily (TID) dosing in patients with normal renal function. This tobramycin regimen appears more effective for treating infections.

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    Area of Science:

    • Pharmacology
    • Infectious Diseases
    • Nephrology

    Background:

    • Tobramycin is an aminoglycoside antibiotic used for serious bacterial infections.
    • Optimizing tobramycin dosing is crucial for efficacy and minimizing nephrotoxicity.
    • Understanding the impact of different dosing frequencies on serum concentrations is essential for therapeutic drug monitoring.

    Purpose of the Study:

    • To compare the serum concentrations of tobramycin achieved with two different dosing regimens (TID vs. BID) in patients with moderate infections.
    • To evaluate the safety and tolerability of bolus tobramycin injections.
    • To determine the preferable tobramycin regimen for patients with normal renal function.

    Main Methods:

    • Eleven patients with moderate infections received tobramycin 4.5 mg/kg/day for 8 days.
    • Patients were randomized to either TID (every 8 hours) for 4 days followed by BID (every 12 hours) for 4 days, or vice versa.
    • Serum tobramycin concentrations were measured on day 2 of each regimen.

    Main Results:

    • The TID regimen resulted in peak serum concentrations less than 4 µg/mL in 5/11 patients, with a mean peak of 4.2 µg/mL.
    • The BID regimen resulted in peak serum concentrations less than 4 µg/mL in only 2/11 patients, with a mean peak of 5.9 µg/mL.
    • Bolus tobramycin injections were well tolerated by all patients.

    Conclusions:

    • The BID tobramycin regimen appears preferable to the TID regimen for achieving therapeutic serum concentrations in patients with normal renal function.
    • Twice-daily dosing may enhance tobramycin efficacy in treating moderate infections.
    • Further studies are warranted to confirm these findings and explore long-term outcomes.

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