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Comparing two-sample log-linear exposure estimation with Bayesian model-informed precision dosing of tobramycin in adult patients with cystic fibrosis.
Antimicrob Agents Chemother
January 2025
InsightRX, San Francisco, California, USA.
Tobramycin dosing in patients with cystic fibrosis (CF) is challenged by its high pharmacokinetic (PK) variability and narrow therapeutic window. Doses are typically individualized using two-sample log-linear regression (LLR) to quantify the area under the concentration-time curve (AUC). Bayesian model-informed precision dosing (MIPD) may allow dose individualization with fewer samples; however, the relative performance of these methods is unknown.
View Article and Find Full Text PDFDetectable Concentrations With Inhaled Tobramycin in Critically Ill Infants and Children Following Implementation of Standardized Protocol.
Ann Pharmacother
September 2024
Department of Pharmacy, Clinical and Administrative Sciences, College of Pharmacy, The University of Oklahoma, Oklahoma City, OK, USA.
Article Synopsis
- A study was conducted on ventilator-associated tracheitis or pneumonia in mechanically ventilated children using inhaled tobramycin at specific intervals to assess drug levels and kidney function.
- The main goal was to find how many patients had tobramycin levels above 0.5 µg/mL, while secondary goals included comparing patient characteristics and tracking any instances of acute kidney injury (AKI).
- Out of 44 patients studied, 68% had detectable drug levels and 20.5% experienced AKI, but no significant differences were found in demographics or medical details between those with and without detectable levels or AKI.
Evaluation of Target Attainment for Tobramycin in Children and Adults with Cystic Fibrosis.
J Clin Med
April 2024
Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, 9712 GZ Groningen, The Netherlands.
Patients with cystic fibrosis (CF) commonly experience pulmonary exacerbations, and it is recommended by the TOPIC study to treat this with tobramycin at a dose of 10 mg/kg once daily. The aim of this study was to evaluate the target attainment of the current dosing regimen. A single-center retrospective cohort study of child and adult patients with CF who received tobramycin between 2019 and 2022 was conducted.
View Article and Find Full Text PDFDoes Sample Size, Sampling Strategy, or Handling of Concentrations Below the Lower Limit of Quantification Matter When Externally Evaluating Population Pharmacokinetic Models?
Eur J Drug Metab Pharmacokinet
July 2024
Faculté de pharmacie, Université de Montréal, 2940 chemin de Polytechnique, Montréal, QC, H3T 1J4, Canada.
Background And Objectives: Precision dosing requires selecting the appropriate population pharmacokinetic model, which can be assessed through external evaluations (EEs). The lack of understanding of how different study design factors influence EE study outcomes makes it challenging to select the most suitable model for clinical use. This study aimed to evaluate the impact of sample size, sampling strategy, and handling of concentrations below the lower limit of quantification (BLQ) on the outcomes of EE for four population pharmacokinetic models using vancomycin and tobramycin as examples.
View Article and Find Full Text PDFTobramycin Systemic Absorption in Lung Transplant Recipients Treated With Inhaled Tobramycin: A Cohort Study.
Transpl Int
April 2024
Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Inhaled tobramycin treatment has been associated with nephrotoxicity in some case reports, but limited data are available about serum levels and its possible systemic absorption in lung transplant recipients (LTR). We conducted a single-center, observational and retrospective study of all adult (>18 years old) LTR treated with inhaled tobramycin for at least 3 days between June 2019 and February 2022. Trough serum levels were collected and >2 μg/mL was considered a high drug level.
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