Systemic exposure to tobramycin after local antibiotic treatment with calcium sulphate as carrier material.

Détails

ID Serval
serval:BIB_DCE890EC0F53
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Systemic exposure to tobramycin after local antibiotic treatment with calcium sulphate as carrier material.
Périodique
Archives of Orthopaedic and Trauma Surgery
Auteur(s)
Wahl P., Livio F., Jacobi M., Gautier E., Buclin T.
ISSN
1434-3916 (Electronic)
ISSN-L
0936-8051
Statut éditorial
Publié
Date de publication
2011
Volume
131
Numéro
5
Pages
657-662
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
INTRODUCTION: Osteoset(®) T is a calcium sulphate void filler containing 4% tobramycin sulphate, used to treat bone and soft tissue infections. Despite systemic exposure to the antibiotic, there are no pharmacokinetic studies in humans published so far. Based on the observations made in our patients, a model predicting tobramycin serum levels and evaluating their toxicity potential is presented.
METHODS: Following implantation of Osteoset(®) T, tobramycin serum concentrations were monitored systematically. A pharmacokinetic analysis was performed using a non-linear mixed effects model based on a one compartment model with first-degree absorption.
RESULTS: Data from 12 patients treated between October 2006 and March 2008 were analysed. Concentration profiles were consistent with the first-order slow release and single-compartment kinetics, whilst showing important variability. Predicted tobramycin serum concentrations depended clearly on both implanted drug amount and renal function.
DISCUSSION AND CONCLUSION: Despite the popularity of aminoglycosides for local antibiotic therapy, pharmacokinetic data for this indication are scarce, and not available for calcium sulphate as carrier material. Systemic exposure to tobramycin after implantation of Osteoset(®) T appears reassuring regarding toxicity potential, except in case of markedly impaired renal function. We recommend in adapting the dosage to the estimated creatinine clearance rather than solely to the patient's weight.
Mots-clé
Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents/administration & dosage, Anti-Bacterial Agents/blood, Bone Diseases, Infectious/drug therapy, Calcium Sulfate/pharmacology, Female, Humans, Joint Diseases/drug therapy, Male, Middle Aged, Soft Tissue Infections/drug therapy, Tobramycin/administration & dosage, Tobramycin/blood
Pubmed
Web of science
Création de la notice
06/05/2011 13:32
Dernière modification de la notice
20/08/2019 16:01
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