Raine P A, Young D G, McAllister T A, Tait S C
J Infect Dis. 1976 Aug;134 Suppl:S165-9. doi: 10.1093/infdis/134.supplement_1.s165.
The new aminoglycoside antibiotic, tobramycin, was used for treatment of gram-negative and staphylococcal infection in 38 neonates, infants, and children in a pediatric surgical unit. Levels of drug in serum after administration by intramuscular, intravenous, and intraperitoneal routes were monitored, and control of infections was generally good within the therapeutic range of 2.0-10.0 mug/ml with a standard dosage regimen of approximately 5 mg/kg per day. Impairment of renal function and concurrent lincomycin therapy were important factors causing variation of levels in serum outside this range. Levels of tobramycin in cerebrospinal fluid after intraventricular instillation varied greatly in one patient, but were satisfactory in another. Clinical and bacteriological assessment of results indicated only two failures of treatment, although infection with a known resistant organism supervened in three cases. Screening for renal, hepatic, and hematological toxicity revealed only one case of transient and reversible renal impairment. Response to tobramycin therapy was generally rapid and satisfactory in a group of young patients with moderately severe infections, many of which were complicated by the presence of a congenital anomaly.
新型氨基糖苷类抗生素妥布霉素被用于一家儿科外科病房的38例新生儿、婴儿及儿童革兰阴性菌和葡萄球菌感染的治疗。监测了通过肌内、静脉及腹腔途径给药后血清中的药物水平，在每日约5mg/kg的标准给药方案下，在2.0 - 10.0μg/ml的治疗范围内感染总体控制良好。肾功能损害及同时使用林可霉素治疗是导致血清水平超出此范围的重要因素。1例患者脑室内滴注后脑脊液中妥布霉素水平差异很大，而另1例则令人满意。结果的临床和细菌学评估显示仅2例治疗失败，尽管3例出现了已知耐药菌感染。对肾、肝及血液学毒性的筛查仅发现1例短暂且可逆的肾功能损害。在一组患有中度严重感染（其中许多伴有先天性异常）的年轻患者中，对妥布霉素治疗的反应通常迅速且令人满意。
