Abstract
This study was aimed to evaluate the dynamics of inhaled tobramycin concentration in bronchoalveolar lavage fluid and blood in victims with nosocomial pneumonia.Materials and Methods. The study is presented as a series of clinical observations: 5 patients with severe concomitant craniocerebral injury were included, who were treated in the general resuscitation unit (men 4 (87.5%), women 1 (12.5%); age 36Ѓ}12 years; Injury Severity Score (ISS) 40.9Ѓ}8.3; acute blood loss volume 2356Ѓ}997 ml; mean bed-days 12.50 days; mortality 16.7%). Statistical analysis of data obtained was carried out using Statistica 10.0 software. Difference was considered significant at p<0.05.Results. The dynamics of tobramycin concentrations was as follows: 1 hr. blood/BAL 0.96Ѓ}0.44 μg/ml / 49.6 μg/ml; 3 hrs. blood/BAL 0.98Ѓ}0.82 μg/ml / 15.5 μg/ml; 5 hrs. blood/BAL 0.79Ѓ}0.83 μg/ml / 3.5 μg/ml. Conclusion.The results obtained confirm significant local concentrations of tobramycin in sputum and low in blood, which corresponds to the results of pharmacokinetic studies and clinical studies of inhaled tobramycin efficacy. At present, gathering of material for the study continues.
Highlights
Inhaled antibiotics (IA, tobramycin, amikacin, colistin etc.), as adjuvant to systemic therapy, are recommended in Russian National Guidelines «Nosocomial Pneumonia in Adults», 2016, as one of the regimens of antibiotic therapies for nosocomial pneumonia (NP)
The study is presented as a series of clinical observations
The study included 5 victims with severe concomitant craniocerebral injury, who were treated in the general resuscitation unit (4 men, 1 woman; age 36±12 years; Injury Severity Score (ISS) 40.9 ± 8.3; acute blood loss volume 2356±997 ml; mean bed-days 12.50 days; mortality 16.7%)
Summary
Inhaled antibiotics (IA, tobramycin, amikacin, colistin etc.), as adjuvant to systemic therapy, are recommended in Russian National Guidelines «Nosocomial Pneumonia in Adults», 2016, as one of the regimens of antibiotic therapies for nosocomial pneumonia (NP). These national guidelines note possibility of use for NP of inhaled ceftazidime 25 mg/kg 3 times a day, amikacin 400–500 mg twice a day (in Russia, there is no officially registered dosage form of ceftazidime or amikacin); tobramycin 300 mg twice a day; colistimethate sodium (colistin, polymyxin Е) 2–3 mln. There are almost no clinical studies supporting high local concentrations of IA at low systemic concentrations in patients with severe concomitant injuries
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
