Klinische Wochenschrift

, Volume 62, Issue 9, pp 394–398 | Cite as

Serum gentamicin concentrations during intratracheal administration

  • F. Vogel
  • M. Exner
  • H. v. Lilienfeld-Toal
  • N. Cattelaens
  • M. Eichelbaum


In artificially ventilated patients, intratracheal aminoglycoside administration is used as a form of prophylaxis of broncho-pulmonary infections. In artificially ventilated patients with multiple organ failure, serum gentamicin concentrations were measured dependent on renal function after endotracheal administration. A standard commercial ampule of 40 mg gentamicin in a 1 ml solution was injected in undiluted form, intratracheally through the tubus, every 6 h. In the patients without renal failure, values over 1 µg/ml were only found in certain individual cases and reached a maximum of 1.5 µg/ml. In patients with renal failure even after prolonged application, the average serum concentrations were between 2 and 3.5 µg/ml. In a very few cases, however, levels of up to 10.5 µg/ml were measured. The daily serum pattern revealed a distinct dependence on the administration; 1 h after administration there was an increase in the serum concentrations which decreased to the initial levels after 6 h. When patients with renal impairment are given an aminoglycoside intratracheally, serum levels of up to 10.5 µg/ml may be reached and thus additional systemic aminoglycoside therapy should be avoided.

Key words

Gentamicin serum concentration Intratracheal administration 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bertelli A, Giovannini L (1980) Fosfomycin Inhibition of Pulmonary Histamine Release Induced by Aminoglycosides. Drugs Exp Clin Res 6(4):329Google Scholar
  2. 2.
    Brain J, Knudson D, Sorokin S, Davis M (1976) Pulmonary Distribution of Particles Given by Intratracheal Instillation or by Aerosol Inhalation. Environ Res 11:13Google Scholar
  3. 3.
    Dally M, Kurrle S, Breslin A (1978) Ventilatory Effects of Aerosol Gentamicin. Thorax 33:54Google Scholar
  4. 4.
    Hellström P, Gruenwaldt G, Scheer M (1976) Serumkonzentration nach Aerosol-Inhalation und intravenöser Injektion von Sisomicin: Vorläufiger Bericht. Infection 4:2Google Scholar
  5. 5.
    Hofmann A, Hameister W, Wahlig H (1974) Inhalation von Gentamicin. Toxikologische und pharmakokinetische Untersuchungen an Ratten. Int J Clin Pharmacol 10:167Google Scholar
  6. 6.
    Hutchison R (1975) Intratracheal Gentamicin and Dexamethasone for Treatment of Infectious Tracheobronchitis in the Dog. Vet Med Small Anim Clin 70:943Google Scholar
  7. 7.
    Klastersky J, Geuning C, Mouawad E, Daneau D (1972) Endotracheal Gentamicin in bronchial infections in patients with tracheostomy. Chest 61:117Google Scholar
  8. 8.
    Klastersky J, Huysmans E, Weerts D, Hensgens C, Daneau D (1974) Endotracheally administered Gentamicin for the prevention of infections of the respiratory tract in patients with tracheostomy. A double-blind study. Chest 65:650Google Scholar
  9. 9.
    Klastersky J, Carpentier-Meunier F, Kahan-Coppens L, Thys J (1979) Endotracheally administered antibiotics for gram-negative bronchopneumonia. Chest 75:586Google Scholar
  10. 10.
    Odio W, van Laer E, Klastersky J (1975) Concentrations of Gentamicin in bronchial secretions after intramuscular and endotracheal administration. J Clin Pharmacol 15:518Google Scholar
  11. 11.
    Pechere J-C, Dugal R (1971) Clinical pharmacokinetics of aminoglycoside antibiotics. Clin Pharmacokinet 4:170Google Scholar
  12. 12.
    Peromet M, Schoutens E, Yourassowsky E (1973) Instillation intratracheale de Gentamicine relation entre les taux seriques obtenus et la creatininemie. Acta Clin Belg 27:578Google Scholar
  13. 13.
    Ramirez R, O'Neill E (1970) Endobronchial Polymyxin B: Experimental observations in chronic bronchitis. Chest 58:352Google Scholar
  14. 14.
    Regula H, Wundt W, Kleinhuber U, Wieser O (1972) Die Aufnahme von Gentamicin über den Bronchialbaum. Münch Med Wochenschr 114:1019Google Scholar
  15. 15.
    Regula H, Wieser O, Naumann P, Wundt W, Kleinhuber U (1973) Pharmakokinetische Untersuchungen über Sputum-, Serum- und Urinkonzentration von Gentamicin nach Aerosol-Inhalation. Int J Clin Pharmacol 71:95Google Scholar
  16. 16.
    Rommelsheim K, Werner H, Vogel F, Exner M (1983) Prophylaxe pulmonaler Infektionen durch intratracheale Aminoglykosid-Instillation. In: Intubation, Tracheotomie und Bronchopulmonale Infektionen, BerlinGoogle Scholar
  17. 17.
    Sculier J, Coppens L, Klastersky J (1982) Effectiveness of mezlocillin and endotracheally administered sisomicin with or without parenteral sisomicin in the treatment of gramnegative bronchopneumonia. J Antimic Chemother 9:63Google Scholar
  18. 18.
    Trnovec T, Navarova J, Kettner M, Greguskova M, Bezek S, Gajdosik A, Kyselova A (1978) Pharmacokinetics of Gentamicin Administered Intratracheally to Rats. Antimicrob Agents Chemother 14:165Google Scholar
  19. 19.
    Vogel F, Spannbrucker N, Ochs H, Rommelsheim K (1981) Serumspiegel von Gentamicin nach intratrachealer und intravesikaler Anwendung. Intensivmed 13:49Google Scholar
  20. 20.
    Vogel F, Werner H, Exner M, Marx M (1981) Prophylaxe und Therapie von Atemwegsinfektionen bei beatmeten Patienten durch intratracheale Aminoglykosid-Gabe. Dtsch Med Wochenschr 106:898Google Scholar
  21. 21.
    Vogel F, Rommelsheim K, Exner M, Krasemann C (1981) Intratracheale Aminoglykosid-Gabe während der Beatmungstherapie. Klinikarzt 10:1218Google Scholar

Copyright information

© Springer-Verlag 1984

Authors and Affiliations

  • F. Vogel
    • 1
  • M. Exner
    • 1
  • H. v. Lilienfeld-Toal
    • 1
  • N. Cattelaens
    • 1
  • M. Eichelbaum
    • 1
  1. 1.Medizinische Klinik und Hygiene-Institut der Universität BonnGermany

Personalised recommendations