Therapeutic Drug Monitoring · 1989 · 17 citations · 0 references
PharmacyInfectious DiseasesPharmacologyAntimicrobial PharmacotherapyAntimicrobial ResistanceMedical MicrobiologyAerosol TherapyAerosolized Medication DeliveryAntibacterial PharmacotherapyAntibiotic ResistanceAntimicrobial DosingPneumonia PharmacotherapyAerosolized AntibioticsAerosolized PreparationsAminoglycoside AntibioticsMinimum Bactericidal ConcentrationPseudomonas Aeruginosa Pneumonia TreatmentPseudomonas Aeruginosa ResistanceRespiratory Bacterial Infections TreatmentRespiratory Tract Infection Treatment
Aerosolized tobramycin was given to a 68-year-old man with resistant Pseudomonas aeruginosa pneumonitis at a dose of 100 mg every 8 h via a tracheostomy, after the patient failed to respond adequately to parenteral aminoglycoside and ticarcillin therapy. Minimum inhibitory concentration and minimum bactericidal concentration for tobramycin and gentamicin were 16 micrograms/ml and greater than 16 micrograms/ml, which necessitated aerosol administration. Tracheal concentrations 15 min and 4 h after a dose were 1,560 and 930 micrograms/ml. The patient responded and eventually was discharged from the hospital. Thus, monotherapy with an aerosolized aminoglycoside may be effective in some patients with resistant Pseudomonas aeruginosa pneumonitis.