Serum gentamicin concentrations during intratracheal administration

• Published in: Klinische Wochenschrift Vol. 62; no. 9; p. 394
• Main Authors: Vogel, F, Exner, M, von Lilienfeld-Toal, H, Cattelaens, N, Eichelbaum, M
• Format: Journal Article
• Language: English
• Published: Germany 02.05.1984
• Subjects: Acute Kidney Injury - blood; Adult; Female; Gentamicins - administration & dosage; Gentamicins - blood; Humans; Intubation, Intratracheal; Kidney Failure, Chronic - blood; Male; Middle Aged; Respiration, Artificial; Respiratory Tract Infections - prevention & control
• ISSN: 0023-2173
• DOI: 10.1007/BF01742295

In artificially ventilated patients, intratracheal aminoglycoside administration is used as a form of prophylaxis of broncho-pulmonary infections. In artificially ventilated patients with multiple organ failure, serum gentamicin concentrations were measured dependent on renal function after endotracheal administration. A standard commercial ampule of 40 mg gentamicin in a 1 ml solution was injected in undiluted form, intratracheally through the tubus , every 6 h. In the patients without renal failure, values over 1 microgram/ml were only found in certain individual cases and reached a maximum of 1.5 micrograms/ml. In patients with renal failure even after prolonged application, the average serum concentrations were between 2 and 3.5 micrograms/ml. In a very few cases, however, levels of up to 10.5 micrograms/ml were measured. The daily serum pattern revealed a distinct dependence on the administration; 1 h after administration there was an increase in the serum concentrations which decreased to the initial levels after 6 h. When patients with renal impairment are given an aminoglycoside intratracheally, serum levels of up to 10.5 micrograms/ml may be reached and thus additional systemic aminoglycoside therapy should be avoided.