Stillwell P C, Kearns G L, Jacobs R F
Division of Pediatric Pulmonology, Phoenix Children's Hospital.
Drug Intell Clin Pharm. 1988 Jul-Aug;22(7-8):577-81. doi: 10.1177/106002808802200713.
This report describes the treatment of resistant gram-negative pneumonitis in a compromised host by the combined use of intravenous and endotracheal tobramycin. The endotracheal administration appeared to have an effect on the serum concentration and elimination rate, necessitating a reduction in the amount of drug given intravenously. The only apparent clinical complication of endotracheal drug administration was transient coughing. The addition of endotracheal aminoglycosides to intravenous antibiotics may be useful in pediatric patients with unresponsive (or other difficult-to-treat) pneumonitis caused by resistant microorganisms. The potential contribution of endotracheal aminoglycosides to the serum level and/or disposition profile must be recognized, and therapeutic drug monitoring guided accordingly when this route of administration is used.
本报告描述了在一名免疫功能低下宿主中，通过静脉和气管内联合使用妥布霉素治疗耐药革兰氏阴性肺炎的情况。气管内给药似乎对血清浓度和消除率有影响，因此需要减少静脉给药量。气管内给药唯一明显的临床并发症是短暂咳嗽。对于由耐药微生物引起的无反应性（或其他难以治疗的）肺炎患儿，在静脉使用抗生素的基础上加用气管内氨基糖苷类药物可能有益。必须认识到气管内氨基糖苷类药物对血清水平和/或处置情况的潜在影响，当采用这种给药途径时，应相应地进行治疗药物监测。
