Systemic tobramycin concentrations during selective decontamination of the digestive tract in intensive care unit patients on continuous venovenous hemofiltration

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). Design and setting Prospective, observation...

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Bibliographic Details
Published in:Intensive care medicine 2008-05, Vol.34 (5), p.903-906
Main Authors: Mol, Meriel, van Kan, Hendrikus J. M., Schultz, Marcus J., de Jonge, Evert
Format: Article
Language:English
Subjects:
Abdomen
Acute Kidney Injury - therapy
Administration, Topical
Adult
Aged
Aged, 80 and over
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthesiology
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - adverse effects
Anti-Bacterial Agents - pharmacokinetics
Antibiotic Prophylaxis - adverse effects
Antibiotics
Biological and medical sciences
Brief Report
Clinical death. Palliative care. Organ gift and preservation
Critical Care Medicine
Disease prevention
Drug-Related Side Effects and Adverse Reactions
Emergency Medicine
Female
Gastrointestinal Tract
Hemofiltration
Humans
Intensive
Intensive care
Intensive care medicine
Intestinal Absorption
Ischemia
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Prospective Studies
Respiratory failure
Sepsis
Tobramycin - adverse effects
Tobramycin - pharmacokinetics
Toxicity
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Summary: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). Design and setting Prospective, observational, single-center study in a mixed medical–surgical ICU. Patients Adult ICU patients receiving SDD for at least 3 days and being treated with CVVH because of acute renal failure. Measurements and 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 ≥ 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.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-008-1020-0