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Clinical pharmacology of tobramycin in infants
Insights
Tobramycin treatment in infants shows variable drug levels. Newborns and premature infants have longer tobramycin serum half-lives and unpredictable concentrations with intramuscular injections.
Area of Science:
- Pharmacology
- Neonatal Medicine
- Pediatric Infectious Diseases
Background:
- Severe infections in infants, particularly neonates and premature infants, require effective antibiotic treatment.
- Tobramycin is an aminoglycoside antibiotic used for serious bacterial infections.
Purpose of the Study:
- To evaluate the pharmacokinetic profile of tobramycin in infants.
- To compare plasma concentrations achieved via intravenous (IV) versus intramuscular (IM) administration.
Main Methods:
- Serum half-life and apparent volume of distribution of tobramycin were determined in two infant groups: those older than one week/above 2,500g and those younger than one week/below 2,500g.
- Plasma drug levels were measured following IV infusion and IM injection.
Main Results:
- Tobramycin serum half-life was significantly longer in younger, smaller infants (8.0 h) compared to older, larger infants (3.5 h).
- Apparent volume of distribution was consistent across both groups (0.24 L/kg).
- IV administration resulted in higher and more predictable plasma concentrations than IM injections, especially in neonates and premature infants.
Conclusions:
- Infant age and weight significantly impact tobramycin's pharmacokinetic profile, necessitating dose adjustments.
- Intravenous administration of tobramycin is preferred for achieving reliable therapeutic drug levels in infants, particularly neonates and premature infants.
Abstract:
Tobramycin was used in the treatment of severe infections in infants, mostly newborns and prematures. Serum half-life of the drug was 3.5 h in infants older than one week and above 2,500 g, and 8.0 h in infants below one week and less than 2,500 g. Apparent volume of distribution was similar in both groups, 0.24 l/kg. Intravenous infusions of the drug gave considerably higher plasma levels than intramuscular infections. Particularly in the newborn and premature group intramuscular injections gave fairly unpredictable plasma concentrations.