The Experts below are selected from a list of 195 Experts worldwide ranked by ideXlab platform
William G. Troutman - One of the best experts on this subject based on the ideXlab platform.
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Tobramycin-induced hypersensitivity reaction.
Annals of Pharmacotherapy, 1995Co-Authors: Janet S Schretlen-doherty, William G. TroutmanAbstract:Objective:To report a case of a hypersensitivity reaction associated with the use of intravenous Tobramycin in a patient with cystic fibrosis.Case Summary:An 18-year-old man was hospitalized for exacerbation of his cystic fibrosis. Tobramycin 125 mg iv q6h and ceftazidime 2 g iv q8h were administered through the patient's implantable access system in the left chest. Within seconds of receiving the third dose of Tobramycin, the patient experienced shaking, his left arm turned white, and urticaria and pruritus were noted on the left side of the patient's chest. The patient had experienced a similar incident, accompanied by breathing difficulty, with intravenous Tobramycin 4 years prior to this incident. The patient had been skin-tested for Tobramycin allergy and had been desensitized and was receiving Tobramycin since that time without incident. The patient's desensitization was maintained with Tobramycin 160 mg/d hs by nebulization, but the drug had been discontinued by the patient 6 months prior to the la...
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Tobramycin-induced hypersensitivity reaction.
The Annals of pharmacotherapy, 1995Co-Authors: Janet S Schretlen-doherty, William G. TroutmanAbstract:To report a case of a hypersensitivity reaction associated with the use of intravenous Tobramycin in a patient with cystic fibrosis. An 18-year-old man was hospitalized for exacerbation of his cystic fibrosis. Tobramycin 125 mg iv q6h and ceftazidime 2 g iv q8h were administered through the patient's implantable access system in the left chest. Within seconds of receiving the third dose of Tobramycin, the patient experienced shaking, his left arm turned white, and urticaria and pruritus were noted on the left side of the patient's chest. The patient had experienced a similar incident, accompanied by breathing difficulty, with intravenous Tobramycin 4 years prior to this incident. The patient had been skin-tested for Tobramycin allergy and had been desensitized and was receiving Tobramycin since that time without incident. The patient's desensitization was maintained with Tobramycin 160 mg/d hs by nebulization, but the drug had been discontinued by the patient 6 months prior to the latest event. Hypersensitivity reactions to aminoglycosides are unusual. Hypersensitivity to 1 aminoglycoside antibiotic frequently is associated with hypersensitivity to at least 1 other amino-glycoside. In patients who develop hypersensitivity to an amino-glycoside antibiotic, desensitization may be an effective alternative to changing therapy. Tobramycin is very important in the drug regimen for Pseudomonas aeruginosa infections in patients with cystic fibrosis. Effective desensitization can be maintained by daily administration of nebulized Tobramycin.
Michael W Konstan - One of the best experts on this subject based on the ideXlab platform.
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Tobramycin inhalation powder for p aeruginosa infection in cystic fibrosis the evolve trial
Pediatric Pulmonology, 2011Co-Authors: Michael W Konstan, Predrag Minic, Florian Brockhaus, David E Geller, Jie Zhang, Gerhild AngyalosiAbstract:Tobramycin inhalation solution is used to treat chronic Pseudomonas aeruginosa lung infection in cystic fibrosis patients. We evaluated the efficacy and safety of a novel, light-porous-particle, dry-powder formulation of Tobramycin, which was developed to improve delivery efficiency to the airways and substantially reduce the delivery time. In this randomized, double-blind study, patients with cystic fibrosis (age 6–21 years) received Tobramycin inhalation powder (112 mg Tobramycin) twice daily (n = 46) or placebo (n = 49) via the T-326 Inhaler for one cycle, followed by two open-label cycles (all patients). Cycles were 28 days on, 28 days off treatment. The primary endpoint was change in FEV1 % predicted from baseline to Day 28 of Cycle 1. The study was terminated early based on positive results in the interim analysis. Tobramycin inhalation powder significantly improved FEV1 % predicted versus placebo at Day 28 (difference 13.3, 95% CI 5.31, 21.28; P = 0.0016). Similar changes in FEV1 were seen in patients switching from placebo to Tobramycin inhalation powder in Cycle 2; improvements were maintained over time. Tobramycin inhalation powder also reduced sputum Pseudomonas aeruginosa density, respiratory-related hospitalization and antipseudomonal antibiotic use versus placebo. The most common adverse event was cough; the frequency of cough was higher in patients receiving placebo (26.5%) versus Tobramycin inhalation powder (13.0%) in Cycle 1. Tobramycin inhalation powder was not associated with ototoxicity or nephrotoxicity. Administration time was between 4 and 6 minutes. In conclusion, Tobramycin inhalation powder was effective and well tolerated in cystic fibrosis patients, and may offer an important treatment option to decrease the treatment burden of cystic fibrosis pseudomonas lung infections.
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Tobramycin inhalation powder for p aeruginosa infection in cystic fibrosis the evolve trial
Pediatric Pulmonology, 2011Co-Authors: Michael W Konstan, Predrag Minic, Florian Brockhaus, David E Geller, Jie Zhang, Gerhild AngyalosiAbstract:Tobramycin inhalation solution is used to treat chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients. We evaluated the efficacy and safety of a novel, light-porous particle, dry-powder formulation of Tobramycin, which was developed to improve delivery efficiency to the airways and substantially reduce the delivery time. In this randomized, double-blind study, patients with CF (age 6-21 years) received Tobramycin inhalation powder (112 mg Tobramycin) twice daily (n = 46) or placebo (n = 49) via the T-326 Inhaler for one cycle, followed by two open-label cycles (all patients). Cycles were 28 days on, 28 days off treatment. The primary endpoint was change in forced expiratory volume in 1 sec (FEV1) % predicted from baseline to Day 28 of Cycle 1. The study was terminated early based on positive results in the interim analysis. Tobramycin inhalation powder significantly improved FEV1 % predicted versus placebo at Day 28 (difference 13.3, 95% CI: 5.31-21.28; P = 0.0016). Similar changes in FEV1 were seen in patients switching from placebo to Tobramycin inhalation powder in Cycle 2; improvements were maintained over time. Tobramycin inhalation powder also reduced sputum P. aeruginosa density, respiratory-related hospitalization and antipseudomonal antibiotic use versus placebo. The most common adverse event was cough; the frequency of cough was higher in patients receiving placebo (26.5%) versus Tobramycin inhalation powder (13.0%) in Cycle 1. Tobramycin inhalation powder was not associated with ototoxicity or nephrotoxicity. Administration time was between 4 and 6 min. In conclusion, Tobramycin inhalation powder was effective and well tolerated in CF patients, and may offer an important treatment option to decrease the treatment burden of CF pseudomonas lung infections.
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the efficacy and safety of meropenem and Tobramycin vs ceftazidime and Tobramycin in the treatment of acute pulmonary exacerbations in patients with cystic fibrosis
Chest, 2005Co-Authors: Jeffrey L Blumer, Michael W Konstan, Lisa Saiman, David MelnickAbstract:Background: Cystic fibrosis (CF) is characterized by chronic pulmonary infection with acute pulmonary exacerbations (APEs) requiring IV antibiotic treatment. We report on a blinded comparative trial of IV meropenem (40 mg/kg to 2 g q8h) or ceftazidime (5 mg/kg to 2 g q8h), each of which was administered with IV Tobramycin (at a serum peak of > 8 g/mL and a trough of 5 years of age who were infected with ceftazidime-susceptible Pseudomonas aeruginosa were stratified by lung function and randomized to treatment with meropenem/Tobramycin or ceftazidime/Tobramycin. Patients infected with Burkholderia cepacia complex or ceftazidime-resistant P aeruginosa were assigned to receive open-label meropenem/ Tobramycin. Clinical response was assessed by spirometry to determine the change in percent predicted FEV1 and by a clinical acute change score (ACS). Results: One hundred two patients were randomized to meropenem/Tobramycin (n 50) or ceftazidime/Tobramycin (n 52). Nineteen patients received open-label meropenem/Tobramycin. FEV1 was improved at the end of treatment (EOT) with meropenem/Tobramycin (mean [ SD] increase, 38.8 52.3%) and with ceftazidime/Tobramycin (mean increase, 29.4 35.1%; p 15% relative increase from baseline FEV1 (satisfactory response) at day 7 was 62% for the meropenem/Tobramycin group and 44% for the ceftazidime/Tobramycin group (p 0.04). The median time to FEV1 response was 4 days for meropenem/Tobramycin therapy vs 6 days for ceftazidime/Tobramycin therapy. Similarly, FEV1 improved in the open-label group (mean increase, 12.5 25.7%; p 0.05). ACS improved in all three groups at EOT (p < 0.0001 vs baseline values). Conclusions: Therapy with both meropenem/Tobramycin and ceftazidime/Tobramycin improved pulmonary and clinical status and reduced sputum bacterial burden in CF patients with APEs. A larger proportion of patients receiving meropenem/Tobramycin therapy demonstrated a satisfactory FEV1 response at day 7. Resistant P aeruginosa emerged infrequently during treatment with both regimens. (CHEST 2005; 128:2336–2346)
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The efficacy and safety of meropenem and Tobramycin vs ceftazidime and Tobramycin in the treatment of acute pulmonary exacerbations in patients with cystic fibrosis.
Chest, 2005Co-Authors: Jeffrey L Blumer, Michael W Konstan, Lisa Saiman, David MelnickAbstract:Cystic fibrosis (CF) is characterized by chronic pulmonary infection with acute pulmonary exacerbations (APEs) requiring IV antibiotic treatment. We report on a blinded comparative trial of IV meropenem (40 mg/kg to 2 g q8h) or ceftazidime (5 mg/kg to 2 g q8h), each of which was administered with IV Tobramycin (at a serum peak of > or = 8 microg/mL and a trough of < 2 microg/mL), as treatment for CF patients with APEs. Patients who were > or = 5 years of age who were infected with ceftazidime-susceptible Pseudomonas aeruginosa were stratified by lung function and randomized to treatment with meropenem/Tobramycin or ceftazidime/Tobramycin. Patients infected with Burkholderia cepacia complex or ceftazidime-resistant P aeruginosa were assigned to receive open-label meropenem/Tobramycin. Clinical response was assessed by spirometry to determine the change in percent predicted FEV1 and by a clinical acute change score (ACS). One hundred two patients were randomized to meropenem/Tobramycin (n = 50) or ceftazidime/Tobramycin (n = 52). Nineteen patients received open-label meropenem/Tobramycin. FEV1 was improved at the end of treatment (EOT) with meropenem/Tobramycin (mean [+/- SD] increase, 38.8 +/- 52.3%) and with ceftazidime/Tobramycin (mean increase, 29.4 +/- 35.1%; p < 0.0001 vs baseline values). The proportion of patients with > or = 15% relative increase from baseline FEV1 (satisfactory response) at day 7 was 62% for the meropenem/Tobramycin group and 44% for the ceftazidime/Tobramycin group (p = 0.04). The median time to FEV1 response was 4 days for meropenem/Tobramycin therapy vs 6 days for ceftazidime/Tobramycin therapy. Similarly, FEV1 improved in the open-label group (mean increase, 12.5 +/- 25.7%; p = 0.05). ACS improved in all three groups at EOT (p < 0.0001 vs baseline values). Therapy with both meropenem/Tobramycin and ceftazidime/Tobramycin improved pulmonary and clinical status and reduced sputum bacterial burden in CF patients with APEs. A larger proportion of patients receiving meropenem/Tobramycin therapy demonstrated a satisfactory FEV1 response at day 7. Resistant P aeruginosa emerged infrequently during treatment with both regimens.
Gerhild Angyalosi - One of the best experts on this subject based on the ideXlab platform.
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Tobramycin inhalation powder for p aeruginosa infection in cystic fibrosis the evolve trial
Pediatric Pulmonology, 2011Co-Authors: Michael W Konstan, Predrag Minic, Florian Brockhaus, David E Geller, Jie Zhang, Gerhild AngyalosiAbstract:Tobramycin inhalation solution is used to treat chronic Pseudomonas aeruginosa lung infection in cystic fibrosis patients. We evaluated the efficacy and safety of a novel, light-porous-particle, dry-powder formulation of Tobramycin, which was developed to improve delivery efficiency to the airways and substantially reduce the delivery time. In this randomized, double-blind study, patients with cystic fibrosis (age 6–21 years) received Tobramycin inhalation powder (112 mg Tobramycin) twice daily (n = 46) or placebo (n = 49) via the T-326 Inhaler for one cycle, followed by two open-label cycles (all patients). Cycles were 28 days on, 28 days off treatment. The primary endpoint was change in FEV1 % predicted from baseline to Day 28 of Cycle 1. The study was terminated early based on positive results in the interim analysis. Tobramycin inhalation powder significantly improved FEV1 % predicted versus placebo at Day 28 (difference 13.3, 95% CI 5.31, 21.28; P = 0.0016). Similar changes in FEV1 were seen in patients switching from placebo to Tobramycin inhalation powder in Cycle 2; improvements were maintained over time. Tobramycin inhalation powder also reduced sputum Pseudomonas aeruginosa density, respiratory-related hospitalization and antipseudomonal antibiotic use versus placebo. The most common adverse event was cough; the frequency of cough was higher in patients receiving placebo (26.5%) versus Tobramycin inhalation powder (13.0%) in Cycle 1. Tobramycin inhalation powder was not associated with ototoxicity or nephrotoxicity. Administration time was between 4 and 6 minutes. In conclusion, Tobramycin inhalation powder was effective and well tolerated in cystic fibrosis patients, and may offer an important treatment option to decrease the treatment burden of cystic fibrosis pseudomonas lung infections.
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Tobramycin inhalation powder for p aeruginosa infection in cystic fibrosis the evolve trial
Pediatric Pulmonology, 2011Co-Authors: Michael W Konstan, Predrag Minic, Florian Brockhaus, David E Geller, Jie Zhang, Gerhild AngyalosiAbstract:Tobramycin inhalation solution is used to treat chronic Pseudomonas aeruginosa lung infection in cystic fibrosis (CF) patients. We evaluated the efficacy and safety of a novel, light-porous particle, dry-powder formulation of Tobramycin, which was developed to improve delivery efficiency to the airways and substantially reduce the delivery time. In this randomized, double-blind study, patients with CF (age 6-21 years) received Tobramycin inhalation powder (112 mg Tobramycin) twice daily (n = 46) or placebo (n = 49) via the T-326 Inhaler for one cycle, followed by two open-label cycles (all patients). Cycles were 28 days on, 28 days off treatment. The primary endpoint was change in forced expiratory volume in 1 sec (FEV1) % predicted from baseline to Day 28 of Cycle 1. The study was terminated early based on positive results in the interim analysis. Tobramycin inhalation powder significantly improved FEV1 % predicted versus placebo at Day 28 (difference 13.3, 95% CI: 5.31-21.28; P = 0.0016). Similar changes in FEV1 were seen in patients switching from placebo to Tobramycin inhalation powder in Cycle 2; improvements were maintained over time. Tobramycin inhalation powder also reduced sputum P. aeruginosa density, respiratory-related hospitalization and antipseudomonal antibiotic use versus placebo. The most common adverse event was cough; the frequency of cough was higher in patients receiving placebo (26.5%) versus Tobramycin inhalation powder (13.0%) in Cycle 1. Tobramycin inhalation powder was not associated with ototoxicity or nephrotoxicity. Administration time was between 4 and 6 min. In conclusion, Tobramycin inhalation powder was effective and well tolerated in CF patients, and may offer an important treatment option to decrease the treatment burden of CF pseudomonas lung infections.
David P Nichols - One of the best experts on this subject based on the ideXlab platform.
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impact of azithromycin on the clinical and antimicrobial effectiveness of Tobramycin in the treatment of cystic fibrosis
Journal of Cystic Fibrosis, 2017Co-Authors: David P Nichols, James F Chmiel, Milene T Saavedra, Jennifer L Taylorcousar, Carrie Happoldt, Preston E Bratcher, Silvia M Caceres, Kenneth C Malcolm, Lisa Saiman, Jerry A NickAbstract:Abstract Background Concomitant use of oral azithromycin and inhaled Tobramycin occurs in approximately half of US cystic fibrosis (CF) patients. Recent data suggest that this combination may be antagonistic. Methods Test the hypothesis that azithromycin reduces the clinical benefits of Tobramycin by analyses of clinical trial data, in vitro modeling of P. aeruginosa antibiotic killing, and regulation of the MexXY efflux pump. Results Ongoing administration of azithromycin associates with reduced ability of inhaled Tobramycin, as compared with aztreonam, to improve lung function and quality of life in a completed clinical trial. In users of azithromycin FEV 1 (L) increased 0.8% during a 4-week period of inhaled Tobramycin and an additional 6.4% during a subsequent 4-week period of inhaled aztreonam (P In vitro , azithromycin selectively reduced the bactericidal effects Tobramycin in cultures of clinical strains of P. aeruginosa , while up regulating antibiotic resistance through MexXY efflux. Conclusions Azithromycin appears capable of reducing the antimicrobial benefits of Tobramycin by inducing adaptive bacterial stress responses in P. aeruginosa , suggesting that these medications together may not be optimal chronic therapy for at least some patients.
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impact of azithromycin on the clinical and antimicrobial effectiveness of Tobramycin in the treatment of cystic fibrosis
Journal of Cystic Fibrosis, 2017Co-Authors: David P Nichols, James F Chmiel, Milene T Saavedra, Jennifer L Taylorcousar, Carrie Happoldt, Preston E Bratcher, Silvia M Caceres, Kenneth C Malcolm, Lisa Saiman, Jerry A NickAbstract:Abstract Background Concomitant use of oral azithromycin and inhaled Tobramycin occurs in approximately half of US cystic fibrosis (CF) patients. Recent data suggest that this combination may be antagonistic. Methods Test the hypothesis that azithromycin reduces the clinical benefits of Tobramycin by analyses of clinical trial data, in vitro modeling of P. aeruginosa antibiotic killing, and regulation of the MexXY efflux pump. Results Ongoing administration of azithromycin associates with reduced ability of inhaled Tobramycin, as compared with aztreonam, to improve lung function and quality of life in a completed clinical trial. In users of azithromycin FEV 1 (L) increased 0.8% during a 4-week period of inhaled Tobramycin and an additional 6.4% during a subsequent 4-week period of inhaled aztreonam (P In vitro , azithromycin selectively reduced the bactericidal effects Tobramycin in cultures of clinical strains of P. aeruginosa , while up regulating antibiotic resistance through MexXY efflux. Conclusions Azithromycin appears capable of reducing the antimicrobial benefits of Tobramycin by inducing adaptive bacterial stress responses in P. aeruginosa , suggesting that these medications together may not be optimal chronic therapy for at least some patients.
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azithromycin may antagonize inhaled Tobramycin when targeting pseudomonas aeruginosa in cystic fibrosis
Annals of the American Thoracic Society, 2014Co-Authors: Jerry A Nick, Samuel M Moskowitz, James F Chmiel, Anna V Forssen, Milene T Saavedra, Jennifer L Taylorcousar, Lisa Saiman, David P NicholsAbstract:Rationale: Recent studies of inhaled Tobramycin in subjects with cystic fibrosis (CF) find less clinical improvement than previously observed. Nonhuman data suggest that in some strains of Pseudomonas aeruginosa, azithromycin can antagonize Tobramycin. Objectives: We tested the hypothesis that concomitant azithromycin use correlates with less improvement in key outcome measures in subjects receiving inhaled Tobramycin while not affecting those receiving a comparative, nonaminoglycoside inhaled antibiotic. Methods: We studied a cohort of 263 subjects with CF enrolled in a recent clinical trial comparing inhaled Tobramycin with aztreonam lysine. We performed a secondary analysis to examine key clinical and microbiologic outcomes based on concomitant, chronic azithromycin use at enrollment. Measurements and Main Results: The cohort randomized to inhaled Tobramycin and reporting azithromycin use showed a significant decrease in the percent predicted FEV1 after one and three courses of inhaled Tobramycin when compared with those not reporting azithromycin use (28 d: −0.51 vs. 3.43%, P < 0.01; 140 d: −1.87 vs. 6.07%, P < 0.01). Combined azithromycin and inhaled Tobramycin use was also associated with earlier need for additional antibiotics, lesser improvement in disease-related quality of life, and a trend toward less reduction in sputum P. aeruginosa density. Subjects randomized to inhaled aztreonam lysine had significantly greater improvement in these outcome measures, which were unaffected by concomitant azithromycin use. Outcomes in those not using azithromycin who received inhaled Tobramycin were not significantly different from subjects receiving aztreonam lysine. Azithromycin also antagonized Tobramycin but not aztreonam lysine in 40% of P. aeruginosa clinical isolates tested in vitro. Conclusions: Oral azithromycin may antagonize the therapeutic benefits of inhaled Tobramycin in subjects with CF with P. aeruginosa airway infection.
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azithromycin may antagonize inhaled Tobramycin when targeting pseudomonas aeruginosa in cystic fibrosis
Annals of the American Thoracic Society, 2014Co-Authors: Jerry A Nick, Samuel M Moskowitz, James F Chmiel, Anna V Forssen, Milene T Saavedra, Jennifer L Taylorcousar, Lisa Saiman, David P NicholsAbstract:Rationale: Recent studies of inhaled Tobramycin in subjects with cystic fibrosis (CF) find less clinical improvement than previously observed. Nonhuman data suggest that in some strains of Pseudomonas aeruginosa, azithromycin can antagonize Tobramycin. Objectives: We tested the hypothesis that concomitant azithromycin use correlates with less improvement in key outcome measures in subjects receiving inhaled Tobramycin while not affecting those receiving a comparative, nonaminoglycoside inhaled antibiotic. Methods: We studied a cohort of 263 subjects with CF enrolled in a recent clinical trial comparing inhaled Tobramycin with aztreonam lysine. We performed a secondary analysis to examine key clinical and microbiologic outcomes based on concomitant, chronic azithromycin use at enrollment. Measurements and Main Results: The cohort randomized to inhaled Tobramycin and reporting azithromycin use showed a significant decrease in the percent predicted FEV1 after one and three courses of inhaled Tobramycin when compared with those not reporting azithromycin use (28 d: −0.51 vs. 3.43%, P < 0.01; 140 d: −1.87 vs. 6.07%, P < 0.01). Combined azithromycin and inhaled Tobramycin use was also associated with earlier need for additional antibiotics, lesser improvement in disease-related quality of life, and a trend toward less reduction in sputum P. aeruginosa density. Subjects randomized to inhaled aztreonam lysine had significantly greater improvement in these outcome measures, which were unaffected by concomitant azithromycin use. Outcomes in those not using azithromycin who received inhaled Tobramycin were not significantly different from subjects receiving aztreonam lysine. Azithromycin also antagonized Tobramycin but not aztreonam lysine in 40% of P. aeruginosa clinical isolates tested in vitro. Conclusions: Oral azithromycin may antagonize the therapeutic benefits of inhaled Tobramycin in subjects with CF with P. aeruginosa airway infection.
Janet S Schretlen-doherty - One of the best experts on this subject based on the ideXlab platform.
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Tobramycin-induced hypersensitivity reaction.
Annals of Pharmacotherapy, 1995Co-Authors: Janet S Schretlen-doherty, William G. TroutmanAbstract:Objective:To report a case of a hypersensitivity reaction associated with the use of intravenous Tobramycin in a patient with cystic fibrosis.Case Summary:An 18-year-old man was hospitalized for exacerbation of his cystic fibrosis. Tobramycin 125 mg iv q6h and ceftazidime 2 g iv q8h were administered through the patient's implantable access system in the left chest. Within seconds of receiving the third dose of Tobramycin, the patient experienced shaking, his left arm turned white, and urticaria and pruritus were noted on the left side of the patient's chest. The patient had experienced a similar incident, accompanied by breathing difficulty, with intravenous Tobramycin 4 years prior to this incident. The patient had been skin-tested for Tobramycin allergy and had been desensitized and was receiving Tobramycin since that time without incident. The patient's desensitization was maintained with Tobramycin 160 mg/d hs by nebulization, but the drug had been discontinued by the patient 6 months prior to the la...
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Tobramycin-induced hypersensitivity reaction.
The Annals of pharmacotherapy, 1995Co-Authors: Janet S Schretlen-doherty, William G. TroutmanAbstract:To report a case of a hypersensitivity reaction associated with the use of intravenous Tobramycin in a patient with cystic fibrosis. An 18-year-old man was hospitalized for exacerbation of his cystic fibrosis. Tobramycin 125 mg iv q6h and ceftazidime 2 g iv q8h were administered through the patient's implantable access system in the left chest. Within seconds of receiving the third dose of Tobramycin, the patient experienced shaking, his left arm turned white, and urticaria and pruritus were noted on the left side of the patient's chest. The patient had experienced a similar incident, accompanied by breathing difficulty, with intravenous Tobramycin 4 years prior to this incident. The patient had been skin-tested for Tobramycin allergy and had been desensitized and was receiving Tobramycin since that time without incident. The patient's desensitization was maintained with Tobramycin 160 mg/d hs by nebulization, but the drug had been discontinued by the patient 6 months prior to the latest event. Hypersensitivity reactions to aminoglycosides are unusual. Hypersensitivity to 1 aminoglycoside antibiotic frequently is associated with hypersensitivity to at least 1 other amino-glycoside. In patients who develop hypersensitivity to an amino-glycoside antibiotic, desensitization may be an effective alternative to changing therapy. Tobramycin is very important in the drug regimen for Pseudomonas aeruginosa infections in patients with cystic fibrosis. Effective desensitization can be maintained by daily administration of nebulized Tobramycin.
