Lung Pharmacokinetics of Tobramycin by Intravenous and Nebulized Dosing in a Mechanically Ventilated Healthy Ovine Model

Editor ’s PerspectiveWhat We Already Know about This TopicFor most bacterial pneumonia, the lung interstitium is considered to be the site of infection, and adequate antibiotic concentrations are important for drug effectDespite systemic antibiotic therapy, therapeutic failure is common, perhaps due to poor lung penetration, and resulting low interstitial space fluid antibiotic concentrationsIncreasing systemic antibiotic doses in order to increase interstitial space fluid antibiotic concentrations could lead to toxicities such as nephrotoxicityWhat This Article Tells Us That Is NewIn a mechanically ventilated healthy large animal model, nebulized tobramycin produced higher peak lung interstitial space fluid concentrations, as well as higher initial epithelial lining fluid concentrations, with lower plasma concentrations than were observed after intravenous administration due to more extensive lung penetrationBackground Nebulized antibiotics may be used to treat ventilator-associated pneumonia. In previous pharmacokinetic studies, lung interstitial space fluid concentrations have never been reported. The aim of the study was to compare intravenous and nebulized tobramycin concentrations in the lung interstitial space fluid, epithelial lining fluid, and plasma in mechanically ventilated sheep with healthy lungs.Methods Ten anesthetized and mechanically ventilated healthy ewes underwent surgical insertion of microdialysis catheters in upper and lower lobes of both lungs a...
Source: Anesthesiology - Category: Anesthesiology Source Type: research

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By STEVEN MERAHN, MD In 1807, in an effort to spite the British and French for shipping interference (and forced recruitment of American citizens into military service), the United States Congress passed an Embargo Act, effectively shutting down trade with these two countries. Britain and France quickly found other trading partners; the US, then limited in our capacity to sell products outside our borders, was left with a devastated economy and a gaping hole in our face. It took only weeks before Congress passed a loophole; they repealed the act within 15 months of its passing. It was a great lesson in unintended co...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Health Policy Politics Uncategorized Health care debate Health Care Reform Steven Merahn universal healthcare Source Type: blogs
Conclusions: While there was evidence that ICU management and bacterial pneumonia increases in children with SRMC, evidence showing an increase in the probability of death or need for mechanical ventilation was inconsistent. Further research using large datasets should evaluate the impact of complications and associated morbidity from influenza in SRMC children.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Original Studies Source Type: research
Abstract Omadacycline, an aminomethylcycline, is a once-daily intravenous (i.v.) and oral antibiotic that is approved in the United States for treatment of adults with acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. In this thorough QT study, the effects of a therapeutic (100 mg i.v.) and a supratherapeutic (300 mg i.v.) dose of omadacycline on the electrocardiogram were studied, with placebo and moxifloxacin as negative and positive controls. Omadacycline at these doses had no effect on the QTc interval. The largest mean placebo-corrected change-from-baseline QTcS (p...
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
Authors: Chen W, Xiong X, Xie B, Ou Y, Hou W, Du M, Chen Y, Chen K, Li J, Pei L, Fu G, Liu D, Huang Y Abstract BACKGROUND: Early diagnosis of invasive fungal disease (IFD) is challenging. High-resolution computed tomography (CT) may improve IFD diagnosis; however, there are no definitive imaging signs for differentiating between bacterial pneumonia and IFD. METHODS: We retrospectively evaluated CT images of 208 patients with IFD (n = 102) or bacterial pneumonia (n = 106). We classified pulmonary opacities as consolidations, ground-glass opacities (GGOs), or nodules and recorded the presence of perinodular groun...
Source: American Journal of Translational Research - Category: Research Tags: Am J Transl Res Source Type: research
Conclusions: EVs induced and released during severe bacterial pneumonia were inflammatory and induced ALI, and HMW HA administration was effective in inhibiting the uptake of EVs by target cells and decreasing lung injury from E.coli EVs or bacterial pneumonia. PMID: 31390880 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Am J Respir Crit Care Med Source Type: research
This Medical Letter review summarizes indications, dosing, and cost of Nuzyra, a semisynthetic tetracycline derivative, for once-daily intravenous and oral treatment of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections in adults
Source: JAMA - Category: General Medicine Source Type: research
Publication date: August 2019Source: Academic Pediatrics, Volume 19, Issue 6Author(s): Ripal Patel, Melissa Schafer, Heidi Ochs, John Andrake, John Pires Ervoes, Eric GershonBackgroundBronchiolitis is the number one cause of hospitalization in children under 2 years of age. AAP guidelines emphasize that only supportive care is needed for bronchiolitis. Data obtained from our institution showed poor adherence to AAP guidelines. This project was undertaken with the goal of improving compliance with these guidelines.Aim StatementOur aim was to reduce length of stay (LOS) for admitted low risk patients with bronchiolitis, age ...
Source: Academic Pediatrics - Category: Pediatrics Source Type: research
A clinical diagnosis of bacterial pneumonia in nursing home residents most often can be treated with a single oral course of antibiotic therapy targeted toward community-acquired pneumonia pathogens, Ghinwa Dumyati, MD, said at the AMDA — The Society for Post-Acute and Long-Term Care Medicine’s annual conference.
Source: Caring for the Ages - Category: Health Management Authors: Source Type: news
Abstract Delafloxacin is a broad-spectrum anionic fluoroquinolone that has completed a Phase 3 study for community acquired bacterial pneumonia. We investigated the pharmacodynamic target for delafloxacin against 12 Klebsiella pneumoniae and 5 Pseudomonas aeruginosa strains in the neutropenic murine lung infection model. The median 24h fAUC/MIC associated with net stasis and 1-log kill was 28.6 and 64.1 for K. pneumoniae, respectively. The 24h fAUC/MIC values associated with net stasis and 1-log kill for P. aeruginosa was 5.66 and 14.3, respectively. PMID: 31332063 [PubMed - as supplied by publisher]
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
ConclusionsChronic and allergic forms of aspergillosis occurred in 17.5% of STAT3-deficient patients, mostly in lung cavities. Almost half had recurrences, despite prolonged antifungal treatment and/or surgery.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
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