Renal and vestibular toxicity due to inhaled tobramycin in a lung transplant recipient.
Chronic rejection is the major hurdle to long-term survival after lung transplantation. Endobronchial infection with Pseudomonas aeruginosa is common in patients with chronic rejection and this may further contribute to deterioration of the allograft. Inhaled tobramycin is commonly used to treat P aeruginosa airways infection in patients with cystic fibrosis. The safety of inhaled tobramycin in transplant recipients, however, has not been established. We describe the first report of a lung transplant recipient who developed renal failure and vestibular injury after receiving inhaled tobramycin. We review the literature regarding the safety of inhaled tobramycin and discuss potential mechanisms that may promote systemic toxicity in transplant recipients.
Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. ahyav@mail.med.upenn.edu
Vivek N
VN
Ahya
Alden M
AM
Doyle
James D
JD
Mendez
David A
DA
Lipson
Jason D
JD
Christie
Emily A
EA
Blumberg
Alberto
A
Pochettino
Linda
L
Nelson
Roy D
RD
Bloom
Robert M
RM
Kotloff
D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000517:prevention & control*; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000503:physiopathology; D014031:Tobramycin / Q000008:administration & dosage / Q000009:adverse effects*; D015837:Vestibular Diseases / Q000139:chemically induced* / Q000503:physiopathology
D000900:Anti-Bacterial Agents; D014031:Tobramycin