Falsely elevated serum tobramycin levels in a patient receiving nebulised tobramycin.
It is common when treating patients with respiratory exacerbations of cystic fibrosis to use both nebulised and intravenous antibiotics. Aminoglycoside drug levels are often measured from finger-prick blood samples. We describe a case of a 14-year-old girl treated simultaneously with IV and nebulised tobramycin in whom drug levels, measured from finger prick blood samples, were erroneously high due to finger contamination by the nebulised drug. Special precautions or direct venepuncture is essential when assessing antibiotic levels in such patients.
Struthers
S L
SL
Cystic Fibrosis Team, Department of Paediatrics, Southampton General Hospital, Tremona Rd, Southampton, SO16 6YD, UK. simonstruthers@hotmail.com
Nicholson
T
T
Jones
G
G
Connett
G J
GJ
D000280:Administration, Inhalation; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000097:blood*; D003550:Cystic Fibrosis / Q000150:complications*; D016903:Drug Monitoring / Q000009:adverse effects* / Q000379:methods; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D009330:Nebulizers and Vaporizers; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000209:etiology; D014031:Tobramycin / Q000008:administration & dosage / Q000097:blood*
D000900:Anti-Bacterial Agents; D014031:Tobramycin