The use of aerosolized tobramycin in the treatment of a resistant pseudomonal pneumonitis.
Aerosolized tobramycin was given to a 68-year-old man with resistant Pseudomonas aeruginosa pneumonitis at a dose of 100 mg every 8 h via a tracheostomy, after the patient failed to respond adequately to parenteral aminoglycoside and ticarcillin therapy. Minimum inhibitory concentration and minimum bactericidal concentration for tobramycin and gentamicin were 16 micrograms/ml and greater than 16 micrograms/ml, which necessitated aerosol administration. Tracheal concentrations 15 min and 4 h after a dose were 1,560 and 930 micrograms/ml. The patient responded and eventually was discharged from the hospital. Thus, monotherapy with an aerosolized aminoglycoside may be effective in some patients with resistant Pseudomonas aeruginosa pneumonitis.
McCall
C Y
CY
Department of Pharmacy Practice, College of Pharmacy, University of Georgia, Athens 30602.
Spruill
W J
WJ
Wade
W E
WE
D000336:Aerosols; D000368:Aged; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000188:drug therapy* / Q000382:microbiology; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology; D014031:Tobramycin / Q000008:administration & dosage / Q000627:therapeutic use*
D000336:Aerosols; D014031:Tobramycin