[Administration of tobramycin aerosols in patients with nosocomial pneumonia: a preliminary study].
OBJECTIVE
The aim of this study was to assess renal and respiratory tolerance of aerosolized tobramycin in intubated and mechanically ventilated patients with nosocomial pneumonia.


METHODS
This was a multicenter, randomized, double-blind, placebo controlled study. Thirty-eight mechanically ventilated patients with documented nosocomial pneumonia were included. Patients treated with intravenous betalactam and tobramycin were randomly allocated to receive aerosolized tobramycin (6 mg/kg/day, n = 21) or placebo (n = 17). The aerosol was administered via a pneumatic nebulizer once a day for 5 days.


RESULTS
Respiratory tolerance was good in all but two patients. No acute renal failure occurred. By day 10, 7 patients in the tobramycin group (35%) had been extubated versus 3 in the placebo group (18.5%, p = 0.18). By day 28, 6 patients had died (2 in the tobramycin group and 4 in the placebo group, p = 0.23).


CONCLUSIONS
Aerosolized tobramycin was well tolerated in ventilated patients with documented nosocomial pneumonia.
Le Conte
P
P
Laboratoire d'Antibiologie Expérimentale, Faculté de médecine de Nantes. pleconte@sante.univ-nantes.fr
Potel
G
G
Clémenti
E
E
Legras
A
A
Villers
D
D
Bironneau
E
E
Cousson
J
J
Baron
D
D
D000328:Adult; D000336:Aerosols; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003404:Creatinine / Q000097:blood; D003428:Cross Infection / Q000188:drug therapy*; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D007668:Kidney / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010919:Placebos; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D012119:Respiration / Q000187:drug effects; D012121:Respiration, Artificial; D013997:Time Factors; D014031:Tobramycin / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D000336:Aerosols; D000900:Anti-Bacterial Agents; D010919:Placebos; D003404:Creatinine; D014031:Tobramycin