[Prevention of pneumonia by endotracheal micronebulization of tobramycin]

In 69 artificially ventilated patients the clinical, bacteriological and pharmacological effects of endotracheally administered tobramycin were studied in comparison to a control group. In the therapy group, 52% of all specimens were sterile, in the control group only 25%. During the first 4 days these changes were significant (p < 0.05). In the therapy group the endotracheal colonisation with ps. aeruginosa was significantly lower between the 4th and 14th day (p < 0.05). The incidence of secondary pneumonia was reduced from 42% to 17.5% (not significant). Systemic administration of antibiotics, e.g. of aminoglycosides, was significantly more often necessary in the control group. No increasing of growth of fungi in the upper respiratory tract was observed, but these was a non-significantly higher incidence mainly of staph. epidermidis. The application of 80 mg tobramycin four times a day as an aerosol was well tolerated by the patients. Under there conditions, tobramycin could not be measured in the serum. No allergic reactions, increased respiratory pressures or bronchoconstrictions were observed.