title: Systemic tobramycin concentrations during selective decontamination of the digestive tract in intensive care unit patients on continuous venovenous hemofiltration.
abstract: OBJECTIVE
  To study whether selective decontamination of the digestive tract (SDD) results in detectable serum tobramycin concentrations in intensive care unit (ICU) patients with acute renal failure treated with continuous venovenous hemofiltration (CVVH).
  
  
  METHODS
  Prospective, observational, single-center study in a mixed medical-surgical ICU.
  
  
  METHODS
  Adult ICU patients receiving SDD for at least 3 days and being treated with CVVH because of acute renal failure.
  
  
  RESULTS
  Tobramycin serum concentrations were measured at the 3rd day after start of CVVH and every 3 days thereafter. Detectable serum concentrations of tobramycin were found in 12 (63%) of 19 patients and in 15 (58%) of the 26 samples. With a toxic tobramycin concentration defined as more than 2.0 mg/l, we found one patient with a toxic concentration of 3.0 mg/l. In three other patients tobramycin concentrations of >or=1.0 mg/l were found.
  
  
  CONCLUSIONS
  In patients with acute renal failure treated with CVVH, administration of SDD with tobramycin can lead to detectable and potentially toxic serum tobramycin concentrations.
authors.affiliation: Department of Intensive Care, Academic Medical Centre University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands. m.mol@amc.uva.nl
authors.forename: Meriel
authors.initials: M
authors.lastname: Mol
authors.forename: Hendrikus J M
authors.initials: HJ
authors.lastname: van Kan
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Schultz
authors.forename: Evert
authors.initials: E
authors.lastname: de Jonge
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D041981:Gastrointestinal Tract; D006440:Hemofiltration; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014031:Tobramycin / Q000009:adverse effects / Q000493:pharmacokinetics*
chemical_list: D000900:Anti-Bacterial Agents; D014031:Tobramycin