Therapeutic Drug Monitoring of Inhaled Tobramycin in a Post–Hematopoietic Cell Transplant Patient With Bronchiolitis Obliterans and End-Stage Renal Disease

There are no widely accepted dose alterations for inhaled tobramycin in the setting of renal dysfunction, and serum concentrations are not typically monitored. Herein we describe a case report of a 16-year-old female with a history of 2 hematopoietic cell transplants and a kidney transplant who rece...

Full description

Saved in:
Bibliographic Details
Published in:The journal of pediatric pharmacology and therapeutics 2020, Vol.25 (5), p.451-454
Main Authors: Trone, Deni J., Hall, Elizabeth A.
Format: Article
Language:English
Subjects:
Case Reports
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:There are no widely accepted dose alterations for inhaled tobramycin in the setting of renal dysfunction, and serum concentrations are not typically monitored. Herein we describe a case report of a 16-year-old female with a history of 2 hematopoietic cell transplants and a kidney transplant who received inhaled tobramycin for chronic Pseudomonas aeruginosa management. The patient developed chronic kidney disease, and tobramycin concentrations were monitored. Initially she received a reduced dose of inhaled tobramycin, with repeated doses based on serum concentrations. The dose was increased, but serum concentrations obtained the following day remained higher than desired, leading to a suspicion of delayed systemic absorption. Tobramycin administration was changed from immediately prior to dialysis to the evening prior to the next day's dialysis session, and serum concentrations were consistently
ISSN:1551-6776
2331-348X
DOI:10.5863/1551-6776-25.5.451