title: [Principles of the prevention of pneumonia by the intratracheal instillation of aminoglycoside antibiotics].
abstract: In long-term respiration the descension of the pharyngeal contents into the tracheobronchial system appears as unavoidable as the colonisation of the oropharynx with pathogens. On the other hand, elimination of the descended pathogens from the trachea and the bronchi by setting up an antibiotic barrier represented by the aminoglycoside antibiotics, can prevent colonisation of the lower respiratory passages. As a matter of fact, the aminoglycoside antibiotics exercise, first of all, rapid and bactericidal action, and secondly a spectrum of pathogens. Intratracheal application of 4 X 40 mg tobramycin daily, distributed over 24 hours, leads in the case of persons with healthy kidneys to serum levels between 0.4 and 0.7 micrograms/ml. Side effects are mainly seen in patients with restricted renal function in the form of cumulative serum concentrations. At present there are no alternative possibilities of prophylaxis against the sequels of descension.
mesh_terms: D000617:Aminoglycosides / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D003422:Critical Care; D004334:Drug Administration Schedule; D006801:Humans; D008826:Microbial Sensitivity Tests; D009960:Oropharynx / Q000382:microbiology; D011014:Pneumonia / Q000382:microbiology / Q000517:prevention & control*; D014132:Trachea / Q000187:drug effects
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents
vernacular_title: Grundlagen der Pneumonieprophylaxe durch die intratracheale Instillation von Aminoglykosid-Antibiotika.