Acute renal failure associated with use of inhaled tobramycin for treatment of chronic airway colonization with Pseudomonas aeruginosa.
Aminoglycoside nephrotoxicity is a well-known clinical entity that complicates the course of infectious diseases treated under this antibiotic regime. Recently, a new administration form of tobramycin, inhaled tobramycin (TOBI), has been approved to improve the antibacterial activity and reduce nephrotoxicity. We describe the clinical case of a 73-year-old woman with chronic-obstructive pulmonary disease (COPD) who developed acute renal failure (ARF) after using TOBI. Clinical presentation and biochemical parameters were compatible with aminoglycoside-induced renal failure. Based on the clinical findings presented here, a surveillance program should be established to monitor the presence of factors predisposing to renal failure, and to measure serum levels of tobramycin.
Izquierdo
M J
MJ
Nephrology Department, "Marques de Valdecilla" Hospital, University of Cantabria, Santander, Cantabria, Spain.
Gomez-Alamillo
C
C
Ortiz
F
F
Calabia
E R
ER
Ruiz
J C
JC
de Francisco
A L M
AL
Arias
M
M
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000280:Administration, Inhalation; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015169:Colony Count, Microbial; D005260:Female; D006801:Humans; D011552:Pseudomonas Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D013902:Radiography, Thoracic; D014031:Tobramycin / Q000008:administration & dosage / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D014031:Tobramycin