title: Anti-Pseudomonas activity in bronchial secretions of patients receiving amikacin or tobramycin as a continuous infusion.
abstract: The penetration of amikacin and tobramycin into bronchial secretions and the resulting anti-Pseudomonas activity were assessed in two groups of tracheostomized or intubated patients with tracheobronchial infection and purulent bronchial secretions. The aminoglycosides were administered as continuous, high-dose intravenous infusions. The mean drug concentrations in serum and bronchial secretions were 12.8 and 2.0 microgram/ml for amikacin and 3.6 and 0.7 microgram/ml for tobramycin. The bronchial secretion/serum ratios varied over a wide range: from 9.6 to 22.8% (average, 14.9%) for amikacin and from 3 to 39.3% (average, 17.5%) for tobramycin. Sustained anti-Pseudomonas activities in bronchial secretions were achieved only in patients with very high aminoglycoside levels in serum. In most patients, however, no anti-Pseudomonas activity could be detected within bronchial secretions despite therapeutic levels of amikacin and tobramycin and adequate bactericidal activities in serum.
mesh_terms: D000583:Amikacin / Q000378:metabolism* / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000378:metabolism*; D001980:Bronchi / Q000378:metabolism*; D006801:Humans; D007263:Infusions, Parenteral; D007612:Kanamycin / Q000031:analogs & derivatives*; D011549:Pseudomonas / Q000187:drug effects*; D014031:Tobramycin / Q000378:metabolism* / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D007612:Kanamycin; D000583:Amikacin; D014031:Tobramycin