Tobramycin Systemic Absorption in Lung Transplant Recipients Treated With Inhaled Tobramycin: A Cohort Study

Autor: Abiu Sempere, Ibai Los-Arcos, Judith Sacanell, Cristina Berastegui, David Campany-Herrero, Jaume Vima, María Teresa Martín-Gómez, Leire Sánchez, Daniel Martínez-González, Carles Bravo, Oscar Len, Joan Gavaldà
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Transplant International, Vol 37 (2024)
Druh dokumentu: article
ISSN: 1432-2277
DOI: 10.3389/ti.2024.12579
Popis: 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. The primary outcome assessed the presence of detectable trough levels, while the secondary outcome focused on the occurrence of acute kidney injury (AKI) in individuals with detectable trough levels. Thirty-four patients, with a median age of 60 years, were enrolled. The primary indications for treatment were donor bronchial aspirate bacterial isolation (18 patients) and tracheobronchitis (15 patients). In total, 28 patients (82%) exhibited detectable serum levels, with 9 (26%) presenting high levels (>2 μg/mL). Furthermore, 9 patients (26%) developed acute kidney injury during the treatment course. Median trough tobramycin levels were significantly elevated in invasively mechanically ventilated patients compared to non-ventilated individuals (2.5 μg/mL vs. 0.48 μg/mL) (p < 0.001). Inhaled tobramycin administration in LTRs, particularly in those requiring invasive mechanical ventilation, may result in substantial systemic absorption.
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