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Pulmonary disposition of tobramycin
The American Review of Respiratory Disease
|May 1, 1983
Summary
Tobramycin levels in bronchoalveolar lavage (BAL) fluid correlate with serum concentrations, but penetration into bronchial secretions differs. Analyzing both BAL fluid and secretions provides a better understanding of antibiotic pharmacokinetics in the lungs.
Area of Science:
- Pharmacology
- Infectious Diseases
- Respiratory Medicine
Background:
- Antibiotic penetration into respiratory secretions varies.
- Previous studies focused on bronchial secretions and blood.
- Understanding drug disposition in different lung compartments is crucial.
Purpose of the Study:
- To quantify tobramycin levels in serum, bronchial secretions, and bronchoalveolar lavage (BAL) fluid.
- To compare tobramycin penetration into bronchial secretions versus BAL fluid.
- To assess the relationship between serum and respiratory fluid tobramycin concentrations.
Main Methods:
- Analysis of tobramycin levels in serum, bronchial secretions, and BAL fluid from 9 patients across 10 studies.
- Correlation analysis between serum and BAL fluid levels, adjusted for creatinine.
- Calculation of drug penetration ratios for bronchial secretions and BAL fluid.
Main Results:
- Serum tobramycin levels significantly correlated with BAL fluid levels (r=0.8, p<0.01).
- Tobramycin penetration into BAL fluid was approximately 0.5 times serum levels.
- Penetration into bronchial secretions was lower, with a secretion-to-serum ratio of 0.2 (r=0.68, p<0.05).
Conclusions:
- Tobramycin disposition differs between bronchial secretions and BAL fluid.
- Measuring tobramycin in both BAL fluid and bronchial secretions offers a more comprehensive pharmacokinetic assessment.
- This approach aids in optimizing antibiotic therapy for respiratory tract infections.