title: Glomerular and Tubular Renal Function after Repeated Once-Daily Tobramycin Courses in Cystic Fibrosis Patients.
abstract: Introduction. Antibiotic treatment regimens againstPseudomonas aeruginosalung infection in cystic fibrosis (CF) patients often include aminoglycoside antibiotics that may cause chronic renal failure after repeated courses. Aminoaciduria is an early marker of acute aminoglycoside-induced renal tubular dysfunction. We hypothesized that urinary amino acid reabsorption is decreased after repeated once-daily tobramycin therapies.Methods. In this prospective cross-sectional study creatinine clearance was estimated by the Schwartz and the Cockcroft-Gault formula. Tubular amino acid reabsorption was determined by ion exchange chromatography in 46 patients with CF who received multiple tobramycin courses (6.3 ± 10.1 (1-57)) in a once-daily dosing regimen and 10 who did not.Results. Estimated creatinine clearance employing the Cockcroft-Gault was mildly reduced in 17/46 (37%) of the patients who received tobramycin and 5/10 (50%) of the patients who did not but in none using the Schwartz formula. No association with lifetime tobramycin courses was found. Tubular amino acid reabsorption was not influenced by the amount of once-daily tobramycin courses.Conclusion. Clinically not significant reduction of eCCL occurred in a minority of CF patients. However, chronic tubular dysfunction was not present in patients with CF repeatedly treated with tobramycin in the once-daily dosing scheme.
authors.affiliation: Pediatric Pulmonology and Sleep Medicine, University Children's Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
authors.forename: Florian
authors.identifier: 0000-0002-2417-2048
authors.initials: F
authors.lastname: Stehling
authors.affiliation: Pediatric Nephrology, University Children's Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Büscher
authors.affiliation: Department of General Pediatrics, Pediatric Respiratory Medicine Unit, University Children's Hospital Muenster, Muenster, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Grosse-Onnebrink
authors.affiliation: Pediatric Nephrology, University Children's Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Hoyer
authors.affiliation: Pediatric Pulmonology and Sleep Medicine, University Children's Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Mellies
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D004334:Drug Administration Schedule; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D007677:Kidney Function Tests / Q000379:methods; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D018410:Pneumonia, Bacterial / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000209:etiology; D065608:Renal Reabsorption / Q000187:drug effects*; D013223:Statistics as Topic; D014031:Tobramycin / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D014031:Tobramycin