Vestibular Toxicity Due to Inhaled Tobramycin in a Patient With Renal Insufficiency

Edson, Randall S.; Brey, Robert H.; McDonald, Thomas J.; Terrell, Christine L.; McCarthy, James T .; Thibert, Janet M .
September 2004
Mayo Clinic Proceedings;Sep2004, Vol. 79 Issue 9, p1185
Academic Journal
The article discusses vestibular toxicity due to inhaled tobramycin in a patient with renal insufficiency. The rationale for aerosolized delivery of aminoglycosides is achievement of high bronchial levels of drug without systemic toxicity. Aminoglycosides can be toxic to the hearing and balance systems. In addition, they can be toxic to the kidneys and thereby exacerbate their deleterious effect on the inner ear. Several studies of the use of acrosolized tobramycin in humans with normal renal function have monitored serum concentrations and found them to be consistently lower than 1 mg/L and often undetectable. Various closes were used in these studies with no ototoxicity or nephrotoxicity reported.


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