Pediatric pulmonology · 2026
Tobramycin Pharmacokinetics in Pediatric People With Cystic Fibrosis on Maintenance Azithromycin.
СтатьяНазвание и аннотация: Перевод в очереди
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Flora Chelsea, Engdahl Samantha, Pettit Rebecca S
Аннотация
BACKGROUND: Many people with cystic fibrosis (PwCF) are colonized with Pseudomonas aeruginosa. Some studies have found that PwCF who use both tobramycin (TOB) and azithromycin during PEx treatment, have worse clinical outcomes, including a greater decline in percent predicted forced expiratory volume (ppFEV1) and lower odds of returning to baseline ppFEV1. The objective of this study was to compare the IV TOB elimination rate constant (Ke) between pediatric PwCF on maintenance azithromycin (mtAZM) versus those not on mtAZM.
METHODS: This IRB-approved retrospective cohort study included pediatric PwCF who received IV TOB for PEx treatment from January 1, 2019-June 1, 2024.
RESULTS: A total of 83 PwCF were included, 35 in mtAZM group and 48 in no mtAZM. Baseline characteristics were similar between both groups. The percentage of females was significantly higher in the mtAZM group (60%) versus the no mtAZM group (38%, p = 0.04). The mean TOB Ke was 0.39 h-1 (0.1) in the mtAZM group versus 0.42 h-1(0.1) in the no mtAZM group (p = 0.07). There were no significant differences between mtAZM versus no mtAZM for other PK parameters. Median TOB daily dose was not significantly different between the two groups (11.2 mg/kg/day (9-12) vs. 10.9 mg/kg/day (9.3-12); p = 0.56). The duration of TOB use, re-admission rate and time to next admission were similar between the two groups. No participants in either group experienced acute kidney injury.
CONCLUSIONS: This study demonstrated that mtAZM did not affect the Ke or other PK parameters of IV TOB. Despite previous reports of interactions between the two medications, our study suggests that similar TOB dosing and monitoring strategies can be used in those PwCF regardless of mtAZM use.
METHODS: This IRB-approved retrospective cohort study included pediatric PwCF who received IV TOB for PEx treatment from January 1, 2019-June 1, 2024.
RESULTS: A total of 83 PwCF were included, 35 in mtAZM group and 48 in no mtAZM. Baseline characteristics were similar between both groups. The percentage of females was significantly higher in the mtAZM group (60%) versus the no mtAZM group (38%, p = 0.04). The mean TOB Ke was 0.39 h-1 (0.1) in the mtAZM group versus 0.42 h-1(0.1) in the no mtAZM group (p = 0.07). There were no significant differences between mtAZM versus no mtAZM for other PK parameters. Median TOB daily dose was not significantly different between the two groups (11.2 mg/kg/day (9-12) vs. 10.9 mg/kg/day (9.3-12); p = 0.56). The duration of TOB use, re-admission rate and time to next admission were similar between the two groups. No participants in either group experienced acute kidney injury.
CONCLUSIONS: This study demonstrated that mtAZM did not affect the Ke or other PK parameters of IV TOB. Despite previous reports of interactions between the two medications, our study suggests that similar TOB dosing and monitoring strategies can be used in those PwCF regardless of mtAZM use.