Summary
The pharmacokinetics and efficacy of a new aminoglycoside, tobramycin, was investigated in the treatment of patients with chronic urinary tract infections and varying degrees of renal impairment. The dosage of tobramycin was 1.5–3 mg/kg body weight divided into three daily doses. The plasma and renal clearance of tobramycin were compared to that of creatinine. Tobramycin was excreted mainly by glomerular filtration and possibly also by tubular secretion in patients with impaired renal function. There were indications of increasing extrarenal elimination in patients with severe renal impairment. Tobramycin was well tolerated following intravenous and intramuscular injection and was effective in the eradication of urinary tract infections due to gram-negative bacteria, especially pseudomonas.
Zusammenfassung
Es wurde die Pharmakokinetik und Wirkung des neuen Aminoglycosids Tobramycin in der Behandlung von Patienten mit chronischer Harnwegsinfektion und unterschiedlichen Graden von Niereninsuffizienz untersucht. Die Tobramycin-Dosis lag zwischen 1,5–3,0 mg/kg Körpergewicht, die in drei Dosen täglich unterteilt wurden. Die Plasma- und Nierenclearance von Tobramycin wurde mit der Kreatininclearance verglichen. Tobramycin wurde hauptsächlich durch glomeruläre Filtration, möglicherweise aber auch durch tubuläre Sekretion bei Patienten mit Niereninsuffizienz ausgeschieden. Mehrere Anzeichen weisen auf eine steigende extrarenale Ausscheidung bei Patienten mit schwerer Niereninsuffizienz hin. Tobramycin wurde nach intravenöser und intramuskulärer Injektion gut vertragen und war wirksam in der Behandlung von Harnwegsinfektionen durch gram-negative Bakterien, besonders von Pseudomonas.
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References
Stark, W. M., Hoehn, M. D., Knox, N. G. Nebramycin, a new broad-spectrum antibiotic complex. Antimicrob. Agents Chemother. 1967. (1968) 314–323.
Black, H. R., Griffith, R. S. Preliminary studies of nebramycin factor 6. Antimicrob. Agents Chemother. 1970 (1971) 314–321.
Preston, D. A., Wick, W. E. Preclinical assessment of the antibacterial activity of nebramycin factor 6. Antimicrob. Agents Chemother. 1970 (1971) 322–327.
Wick, W. E., Welles, J. S. Nebramycin, a new broadspectrum antibiotic complex: IV. In vitro and in vivo laboratory evaluation. Antimicrob. Agents Chemother. 1967 (1968) 341–348.
Shadomy, S., Kirchhoff, C. In vitro susceptibility testing with tobramycin. Antimicrob. Agents Chemother. 1 (1972) 412–416.
Traub, W. H., Raymond, E. A. Evaluation of the in vitro activity of tobramycin as compared with that of gentamicin sulfate. Appl. Microbiol. 1 (1972) 4–7.
Levison, M. E., Knight, R., Kaye, D. In vitro evaluation of tobramycin, a new aminoglycoside antibiotic. Antimicrob. Agents Chemother. 1 (1972) 381–384.
Crowe, C. C., Sanders, E. Sisomicin: evaluation in vitro and comparison with gentamicin and tobramycin. Antimicrob. Agents Chemother. 3 (1973) 24–28.
Brusch, J. L., Barza, M., Bergeron, M. G., Weinstein, L. Cross-resistance of Pseudomonas to gentamicin and tobramycin. Antimicrob. Agents Chemother. 1 (1972) 280–281.
Naber, K. G., Westenfelder, S. R., Madsen, P. O. Pharmacokinetics of the aminoglycoside antibiotic tobramycin in humans. Antimicrob. Agents Chemother. 3 (1973) 469–473.
Wagner, J. G. (1970) Pharmacokinetic notes. J. M. Richards Laboratory, Grosse Pointe Park, Michigan, p. 114–123.
Lockwood, W. R., Bower, J. D. Tobramycin and gentamicin concentrations in the serum of normal and anephric patients. Antimicrob. Agents Chemother. 3 (1973) 125–129.
Gordon, R. C., Regamey, C., Kirby, W. M. M. Serum protein binding of the aminoglycoside antibiotics. Antimicrob. Agents Chemother. 1 (1972) 214–216.
Craig, W. A., Kunin, C. M. Trimethoprim-sulfamethoxazole: effect of impaired renal function and urinary pH on pharmacodynamics in man. Ann. Int. Med. 78 (1973) 491–497.
Sabath, L. D., Casey, J. I., Ruch, P. A., Stumpf, L. L., Finland, M. Rapid microassay for circulating nephrotoxic antibiotic. Antimicrob. Agents Chemother. 1970 (1971) 83–90.
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Westenfelder, S.R., Welling, P.G. & Madsen, P.O. Efficacy and pharmacokinetics of tobramycin in patients with chronic urinary tract infections and various degrees of renal impairment. Infection 2, 76–79 (1974). https://doi.org/10.1007/BF01642025
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DOI: https://doi.org/10.1007/BF01642025